Disease Detective Entrance Exam

Public Health Approach

Treatment

John Snow

Edward Jenner

Mantel and Haenszel

Social and societal characteristics is the most important determinant of health

Mental health

It generates hypotheses and answers the questions who, what, when, and where of the disease or infection

The investigators control the circumstances and randomly determine who receives the test vaccine

Vector

Zoonosis

Infectious dose

The rate of occurrence of an event; number of new cases of disease occurring over a specified period of time

To provide information that can be used for health action by public health personnel, government leaders, and the public to guide public health policy and programs

To assess effectiveness of programs and control measures

Passive surveillance relies on physicians to report cases, while active surveillance involves health agencies actively searching for cases

Sentinel surveillance is only conducted in selected locations.

Analyzing medical data to detect or anticipate disease outbreaks.

Sentinel surveillance

It is not effective for detecting rare diseases.

Sporadic

Risk

Rate

Clinical Approach = Individuals Public Health Approach = Populations

Clinical Approach = Diagnosis and Treatment Public Health Approach = Prevention and Health Promotion

Clinical Approach = Human Behavior and Lifestyle, and Medical Care Public Health Approach = Interventions aimed at Environment, Medical Care

Genes and biology = Influence health to a lesser extent compared to other determinants Health behaviors = Includes nutrition and physical activity Social and societal characteristics = Includes social and cultural norms that influence food choices and physical activity Access to and use of health services and medical care = Determines about 25% of our health

Collect Data = Involves surveillance and determining Time/Place/Person triad Assessment = Involves inference Hypothesis testing = Determines how and why Action = Involves intervention

Descriptive Epidemiology = Identifies the time, place, and person involved in the onset of the health-related event Analytical Epidemiology = Finds the causes of the health-related event and identifies the interventions of the health problem

Experimental Study = Investigators can control certain factors within the study from the beginning Observational Study = Epidemiologist does not control the circumstances

John Snow = First studies in analytic epidemiology William Farr = Developed basic practices used today in vital statistics and disease classification Robert Koch = Formalized standards to identify organisms with infectious diseases Joseph Goldberger = Descriptive field study showing the dietary origin of pellagra

Scurvy = James Lind used a concurrently treated control group in its study Anthrax = Louis Pasteur recognized the bacterial cause and developed a vaccine Smallpox = Worldwide eradication in the 1970's Cholera = John Snow formed and tested hypothesis on its waterborne transmission

Determinant = Factor that contributes to the generation of a trait Epidemic = Occurrence in a community or region of cases of an illness or health-related events clearly in excess of normal expectancy Health outcome = Result of a medical condition that directly affects the length or quality of a person’s life Clinical care = Prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by medical and allied health professions

Incidence = Rate of occurrence of new cases of disease over a specified period of time Prevalence = Number of cases of disease occurring within a population at any one given point in time Surveillance = Ongoing, systematic collection, analysis, and interpretation of health-related data Goal of Public Health Surveillance = Provide information that can be used for health action to guide public health policy and programs

Passive Surveillance = Diseases are reported to health care providers Active Surveillance = Health agencies contact health providers seeking reports Data Collection = Process includes reported diseases or syndromes, electronic health records, vital records, registries, and surveys Data Dissemination = Process includes distribution of information to public health practitioners, clinicians, policy makers, community organizations, and the general public

Data Analysis = Examination of reports either by where the case was reported or where the illnesses occurred Data Interpretation = Identifying the person, place, and time to determine how and why the health event happened Data Dissemination = Distribution of information to those who need to know Link to Action = Without action, the collected data serve no real purpose

911 systems = Emergency services Federal agencies = Government Hospitals = Healthcare Schools = Education

Agent = A microbial organism with the ability to cause disease Reservoir = A place where agents can thrive and reproduce Portal of exit = A place of exit providing a way for an agent to leave the reservoir Mode of transmission = Method of transfer by which the organism moves or is carried from one place to another

Susceptible host = A person who cannot resist an microorganism invading the body, multiplying and resulting in infection Fomite = A physical object that serves to transmit an infectious agent from person to person Zoonosis = An infectious disease that is transmissible from animals to humans Infectious dose = The amount of pathogen (measured in number of microorganisms) required to cause an infection in the host

Contamination = When a potentially infectious agent exists in the host but has not yet in invaded the tissues of the host Infection = When the infectious agent begins its invasion of the host tissue and its rapid multiplication Disease = When the cumulative effects of the infection cause damage in the tissues Virulence = Refers to the proportion of persons with clinical disease who become severely ill or die

Vector = An animate intermediary in the indirect transmission of an agent that carries the agent from a reservoir to a susceptible host Pathogenicity = Refers to the proportion of infected persons who develop clinical disease Period of communicability = The period when you are infectious and can spread your germs (whether bacteria, viruses, or parasites) to an uninfected person Infectivity = Refers to the proportion of exposed persons who become infected

Sentinel Surveillance = May not be as effective for detecting rare diseases or diseases that occur outside the catchment areas of the sentinel sites Syndromic Surveillance = Monitors data from school absenteeism logs, emergency call systems, over-the-counter drug sale records, Internet searches, and other data sources to detect unusual patterns

Sentinel Surveillance = A network of large hospitals might be used to collect high-quality data on various diseases and their causative organisms Syndromic Surveillance = In an influenza outbreak, this method will monitor data from school absenteeism logs, emergency call systems, over-the-counter drug sale records, etc. to detect unusual patterns

Sentinel Surveillance = Involves only a limited network of carefully selected reporting sites Syndromic Surveillance = Its use for detecting outbreaks associated with bioterrorism is increasingly being explored by public health officials

Sentinel Surveillance = Used to monitor trends or key health indicators Syndromic Surveillance = Used to alert disease epidemiologists and public health professionals when there may be an issue

Endemic = Disease or condition present among a population at all times Outbreak = More cases of a particular disease than expected in a given area or among a specialized group of people over a particular period of time Pandemic = An epidemic occurring over a very wide area (several countries or continents) and usually affecting a large proportion of the population Sporadic = A disease that occurs infrequently and irregularly

Mutualism = Both organisms benefit Commensalism = One organisms benefits and the other is not harmed or helped Parasitism = One organism is helped and the other is harmed

Natural History of Disease = Refers to the progression of a disease process in an individual over time, in the absence of treatment State of Susceptibility = The process begins with the appropriate exposure to or accumulation of factors sufficient for the disease process to begin in a susceptible host Incubation Period = Stage of subclinical disease, extending from the time of exposure to onset of disease symptoms Latency Period = For chronic diseases, the period after the disease process has been triggered, pathological changes then occur without the individual being aware of them

Risk = The probability that an individual will be affected by, or die from, an illness or injury within a stated time or age span Rate = Number of cases occurring during a specific period; always dependent on the size of the population during that period Ratio = Value obtained by dividing one quantity by another – often compares two rates Proportion = The comparison of a part to the whole as the number of cases divided by the total population

False

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Individuals

Control and prevention of disease in populations or groups of individuals

Clinical medicine focuses on individuals while public health focuses on populations or groups of individuals

William Farr

Edward Jenner

determinant

1964

Genes and biology, health behaviors, social and societal characteristics, access to and use of health services and medical care

25%

Social and cultural norms, environmental characteristics, sector influences

Alcohol-related harms, food safety, healthcare-associated infections, heart disease and stroke, HIV, motor vehicle injury, nutrition, physical activity and obesity, prescription drug overdose, teen pregnancy, tobacco use

An endemic refers to a disease or condition that is present among a population at all times. An outbreak, on the other hand, refers to the occurrence of more cases of a particular disease than expected in a given area or among a specialized group of people over a particular period of time.

An epidemic refers to a situation where there are large numbers of people over a wide geographic area affected by a particular disease.

A cluster refers to an aggregation of cases over a particular period, closely grouped in time and space, regardless of whether the number is more than the expected number. Sporadic cases, on the other hand, refer to a disease that occurs infrequently and irregularly.

Natural history of disease refers to the progression of a disease process in an individual over time, in the absence of treatment. It includes the stages of susceptibility, exposure, subclinical disease, onset of symptoms, diagnosis, clinical disease, recovery, disability, or death.

vector, fomite, zoonosis, bacteria, viruses, fungi, protozoa, algae, parasitic worms, prions

the young, the elderly, and people with weakened immune systems

contaminated food, environment that allows a vector to introduce the agent into the host, air that allows an agent to be inhaled by a host, and agents spread by contact between two people

infectivity, pathogenicity, and virulence

The goal of public health surveillance is to provide information that can be used for health action by public health personnel, government leaders, and the public to guide public health policy and programs.

The purposes of surveillance in public health are to assess public health status, define public health priorities, evaluate programs, stimulate research.

The 5 steps in the public health surveillance process are data collection, data analysis, data interpretation, data dissemination, and link to action.

The types of surveillance are passive surveillance and active surveillance. Passive surveillance involves diseases being reported to health care providers and is simple and inexpensive but limited by incompleteness of reporting and variability of quality. Active surveillance involves health agencies contacting health providers seeking reports and ensures more complete reporting of conditions, but is more resource-intensive.

Sentinel surveillance is the reporting of health events by selected health professionals to obtain high-quality data about a particular disease that cannot be obtained through a passive system. It can be used when monitoring trends or key health indicators, and involves only a limited network of carefully selected reporting sites.

The advantages of sentinel surveillance include the ability to signal trends, identify outbreaks, and monitor the burden of disease in a community. It provides a rapid and economical alternative to other surveillance methods. However, it may not be as effective for detecting rare diseases or diseases that occur outside the catchment areas of the sentinel sites.

Syndromic surveillance systems monitor data from school absenteeism logs, emergency call systems, hospitals' over-the-counter drug sale records, Internet searches, and other data sources to detect unusual patterns.