Cholera and Legionnaires' Disease Cases

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Questions and Answers

What is the primary design type for most cohort studies?

  • Retrospective
  • Cross-sectional
  • Randomized controlled
  • Prospective (correct)

What does the relative risk in a cohort study indicate?

  • The average age of participants
  • How much exposure increases the likelihood of disease (correct)
  • The number of participants enrolled
  • The duration of the study

In the example provided, what was the risk ratio of developing lung cancer for smokers compared to non-smokers?

  • 25:5
  • 2:1
  • 10:1
  • 5:1 (correct)

In the cited cohort study, how was the participant's disease status monitored?

<p>Via follow-up surveys annually (B)</p> Signup and view all the answers

What is an example of a retrospective approach in cohort studies?

<p>Reviewing past medical records for exposure history (B)</p> Signup and view all the answers

What method is most likely used to collect data from individual persons in community health studies?

<p>Questionnaires and surveys (A)</p> Signup and view all the answers

Which of the following best describes the purpose of conducting health studies?

<p>To discover associations between risk factors and health outcomes (A)</p> Signup and view all the answers

In a cross-sectional study, which characteristic defines the population being studied?

<p>Patients are studied due to their inclusion in a certain group (A)</p> Signup and view all the answers

How are environmental changes monitored in health studies?

<p>With sensors designed for environmental data (A)</p> Signup and view all the answers

What type of data might a study use from nonhealth-related sources?

<p>Intoxicated driver arrest records (B)</p> Signup and view all the answers

What time of day shows peaks in farm tractor-associated deaths?

<p>Just before lunch and late afternoon (A)</p> Signup and view all the answers

Which demographic experienced an increase in fatalities associated with farm tractors?

<p>Older persons (B)</p> Signup and view all the answers

In which geographical region did most farm tractor-associated deaths occur?

<p>Northern Georgia (D)</p> Signup and view all the answers

What type of study is being conducted if an epidemiologist examines sleep patterns without intervention?

<p>Observational (C)</p> Signup and view all the answers

What is indicated by the fewer deaths during lunch hours?

<p>Farmers are on break from work (B)</p> Signup and view all the answers

Which option represents an example of an analytic study?

<p>Comparing diets of those with and without heart disease (D)</p> Signup and view all the answers

Which factor could contribute to the increase in deaths in the late afternoon?

<p>Fatigue from a day of work (D)</p> Signup and view all the answers

The data collection method used to analyze deaths associated with farm tractors is primarily which type?

<p>Retrospective analysis (D)</p> Signup and view all the answers

What condition was named after the American Legion Convention due to pneumonia cases?

<p>Legionnaires’ Disease (B)</p> Signup and view all the answers

Which age group had the highest percentage of illness among hotel guests during the outbreak?

<p>≥70 years (C)</p> Signup and view all the answers

What was a common factor identified among the ill men during the legionnaires' disease outbreak?

<p>The specific hotel they stayed in (C)</p> Signup and view all the answers

What evidence did Snow use to identify the source of cholera in his investigation?

<p>He created a spot map marking water pumps. (D)</p> Signup and view all the answers

In the context of the outbreak, what is the first step investigators should take to calculate the rate of illness?

<p>The size of the conference population (C)</p> Signup and view all the answers

Which age group had the lowest percentage of sickness according to the data?

<p>≥39 years (B)</p> Signup and view all the answers

How many deaths were reported among attendees of the American Legion Convention by August 2, 1976?

<p>18 deaths (C)</p> Signup and view all the answers

What was the total number of individuals who became ill in the 50–59 age group?

<p>27 (D)</p> Signup and view all the answers

What symptoms did attendees of the American Legion Convention experience?

<p>Malaise, dry cough, and muscle pain (D)</p> Signup and view all the answers

What type of symptoms did the individuals at the technology conference experience?

<p>Flu-like symptoms (B)</p> Signup and view all the answers

What was the timeframe during which the American Legion Convention took place?

<p>July 21-24 (B)</p> Signup and view all the answers

After the convention, when did the first cases of severe respiratory illness get reported to the CDC?

<p>August 2 (B)</p> Signup and view all the answers

What was the age percentage for the 60–69 age group that became ill?

<p>11.1% (C)</p> Signup and view all the answers

What type of illness did the conventioneers suffer from after attending the event?

<p>Severe respiratory illness (D)</p> Signup and view all the answers

How many additional cases were uncovered after conversations with public health officials on August 2?

<p>71 cases (D)</p> Signup and view all the answers

What was the main public health concern raised regarding the American Legion Convention?

<p>Severe pneumonia cases (D)</p> Signup and view all the answers

What is a defining characteristic of an experimental study in epidemiology?

<p>Investigators randomly assign participants to different groups. (D)</p> Signup and view all the answers

What distinguishes descriptive epidemiology from analytic epidemiology?

<p>Descriptive epidemiology summarizes health events without control. (D)</p> Signup and view all the answers

Which of the following is an example of an analytic epidemiological question?

<p>Why did the population experience an increase in health problems? (C)</p> Signup and view all the answers

In the context of the farm tractor study mentioned, what aspect of epidemiology was likely employed?

<p>Descriptive study using pre-existing data sources. (B)</p> Signup and view all the answers

What primary question does descriptive epidemiology aim to answer?

<p>When, where, and who are affected? (C)</p> Signup and view all the answers

What is the focus of analytic epidemiology?

<p>Determining causative conditions and risk factors. (B)</p> Signup and view all the answers

Which statement accurately reflects the purpose of an observational study?

<p>Data is collected to draw conclusions without intervention from the researcher. (A)</p> Signup and view all the answers

In epidemiology, what kind of study is likely to involve randomized control groups?

<p>Experimental epidemiology. (B)</p> Signup and view all the answers

Flashcards

Number of Cases

The number of individuals who experienced the health issue in a specific population.

Population Size

The total number of individuals in a specific group or population.

Time Period

The time period over which a health event occurs.

Rate Calculation

The rate at which a health event occurs in a specific population.

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Attack Rate

The rate at which a health event occurs in a specific population during a set time period.

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Cohort

A group of people who share a common characteristic or experience, such as attending a conference or staying at a specific hotel.

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Common Factor

A characteristic that is shared by all cases in an outbreak, and is not shared by those who are not ill.

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Epidemiological Investigation

The process of identifying the source of an outbreak by studying the characteristics of those who are ill and comparing them to those who are not ill.

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Spot map

A visual representation of the location of events (e.g., deaths) in a specific area. It helps epidemiologists identify patterns and potential sources of disease.

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Point-source outbreak

A common source outbreak that spreads from a single source, like contaminated water or food, to multiple individuals. The impact of this type of outbreak can be quick and widespread.

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Unexplained Outbreak

An outbreak where the source of infection is unknown or not easily identified. It can be challenging to control and contain.

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Clinical Presentation

The characteristic symptoms, signs, and course of a disease.

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Disease surveillance

The collection of cases of a disease reported over a specific period of time. It can be used to assess the prevalence and trends of a disease in a population.

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Cases

People who get sick from a common source. The connection between the source and the cases is usually easy to identify.

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Carrier

A person who is exposed to a disease but does not develop symptoms. They can still transmit the disease to others.

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Experimental Studies

Studies where researchers actively control factors to investigate a hypothesis, often involving random assignment of participants to groups. An example is clinical trials for new vaccines.

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Observational Studies

Research that observes and analyzes existing data without directly manipulating the factors being studied. It is broken down into two categories: descriptive and analytic.

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Descriptive Epidemiology

A type of observational study focused on characterizing patterns and summarizing information about a health event or problem. It answers questions like when, where and who is affected.

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Analytic Epidemiology

A type of observational study that examines relationships and potential causes of health problems. It seeks to investigate factors that contribute to the problem, answering questions like 'why' and 'how'.

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Descriptive Epidemiology Approach

A research approach that focuses on describing and characterizing the characteristics and distribution of a disease or health event within a population.

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Analytic Epidemiology Approach

A research approach that delves into the factors that contribute to the occurrence of a disease or health event, investigating potential causes, risk factors, and associations.

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Existing Surveillance System

A collection of information about a health event, such as death records, that is routinely gathered and analyzed to monitor trends.

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Epidemiology Approach and Methods

The process of systematically collecting and analyzing data to investigate health events and patterns. This involves different types of studies, with varying approaches to understanding and addressing health issues.

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Cohort Study

A study where researchers observe a group of people over time to identify any associations between exposure and health outcomes. This helps understand long-term effects of factors on health.

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Cross-Sectional Study

A study that examines a snapshot of a population at a single point in time, to look for relationships between health outcomes and exposures. It's like taking a picture of the population.

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Data Sources in Epidemiology

A research method that gathers data from various sources, such as individuals, the environment, healthcare providers, and even non-health related sources like sales records. This offers a comprehensive view of a health issue.

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Study Design in Epidemiology

A research approach that aims to discover connections between an exposure or risk factor and a health outcome. It's like figuring out if there's a link between something people are exposed to and their health.

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Descriptive Study

A type of study that describes the characteristics of a population or health event, such as time, place, and person.

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Analytic Study

A type of study that examines the relationship between two or more variables, such as exposure to a risk factor and the development of a disease.

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Longitudinal Study

A study that involves collecting data from individuals over time to track changes in health status or other factors.

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Case-Control Study

A type of study that compares the characteristics of individuals with a disease to those without the disease, aiming to identify factors that may have contributed to the disease.

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Relative Risk

A measure in cohort studies that compares the risk of developing a disease in an exposed group to the risk in an unexposed group. It's calculated as the ratio of the incidence rate in the exposed group to the incidence rate in the unexposed group.

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Prospective Cohort Study

A study design where researchers identify individuals with and without a specific exposure at a point in time and then follow them forward to see who develops the outcome of interest. This is the most common type of cohort study.

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Retrospective Cohort Study

A study design where data on exposure and outcome are collected retrospectively, meaning researchers look back in time to see if those who developed the outcome had the exposure.

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Study Notes

Cholera Outbreak in London, 1854

  • John Snow, a physician, identified contaminated water as the source of the cholera outbreak in London's Golden Square area in 1854.
  • Snow's spot map pinpointed water pumps, later correlating their location to the distribution of cholera cases.
  • He noted a higher concentration of cholera cases near the Broad Street pump compared to other pumps.

Unexplained Pneumonia (Legionnaires' Disease)

  • A cluster of severe respiratory illnesses occurred among attendees of the 1976 American Legion Convention in Philadelphia.
  • The illness, characterized by pneumonia symptoms, resulted in 18 deaths and 71 additional reported cases.
  • Health officials at veterans' hospitals in Philadelphia pinpointed a link between the illness and a specific hotel, Hotel A.

Legionnaires' Disease: Age Group Data (1976)

  • The data shows a higher proportion of Legionnaires' disease cases among older attendees of Hotel A, Specifically those aged 60+.

Conducting Epidemiological Studies

  • Epidemiological studies aim to uncover associations between exposures( risk factors) and health outcomes.

Types of Epidemiological Studies

  • Experimental: Investigators control certain factors (e.g., vaccine trials).
  • Observational: Investigators don't control the circumstances.
    • Descriptive: Characterizes and summarizes health events (e.g., describing the occurrence of farm tractor fatalities in Georgia).
      • Examines when, where, who, and how disease occurs.
    • Analytic: Examines comparisons between groups to determine the role of causative conditions or risk factors.
      • Investigates the causal relationships between exposure and outcome.

Data Sources in Epidemiology

  • Individual persons: Questionnaires, surveys, and interviews.
  • Environment: Samples from the surrounding environment, environmental changes, and sensor data.
  • Health care providers: Health records, notifications of diseases, reports of cases of meningitis.
  • Non-health-related sources: Court records, sales records, and reports of accidents (e.g., farm tractor fatalities).

Cross-Sectional Studies

  • Examines the prevalence of a disease or risk factors within a population at a specific point in time.
    • Useful for estimating prevalence and identifying associations between characteristics and exposures but don't show causation.
    • Subjects are sampled based on group membership (age, location, etc) and no long-term follow-up is required.
    • Examples: surveying New Yorkers on smoking and coffee consumption, or analyzing national U.S. data on lung cancer rates in different geographic locations, or looking at the prevalence of genetic markers for diabetes among a population.

Cohort Studies

  • Identifies a group( cohort) and tracks them over time to determine whether exposures affect the group's health
    • Prospective: Follow a group of individuals forward in time to see if exposures increase or decrease the likelihood of developing a disease.
    • Retrospective: Examine past data from events that have already happened to see whether exposures increases the likelihood of developing a disease.
    • Examines trends and determines the relative risk of developing disease.

Case-Control Studies

  • Investigators start with a group of individuals with the outcome of interest (e.g., lung cancer) and a control group.
  • The study compares factors (exposures) in the two groups to identify factors potentially associated with the presence of disease.
    • Useful to explore past exposures, but do not measure prevalence.

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