MICR 223 lecture 1

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Lecture 1
Paige Waddington
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Paige Waddington
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Frage Antworten
define epidemiology epidemiology is the study of the distribution of health-related states or events in specified populations, and the application of this study to the control of health problems
what type of questions do epidemiologists ask How many? who? when? where? risk factors?
is every population equally likely to catch a disease, or equally likely to become very sick from a disease .......
case study: how we came to understand the cause of microcephaly in Brazil and what to do about it main points most regions use a chemical pesticide to treat drinking water in brazil 2014 - widespread switch from one pesticide (Tempos) to a second (Pyriproxyfen) due to mosquitos becoming resistant 2015 - reports of a large increase in microcephalic infants to WHO epidemiologists collected prevalence data where this part of brazil had 14 municipalities and 11 of these used the new pesticide in their drinking water. the other 3 controlled mosquitoes by adding a biological mosquito control agent to water if pyriproxyfen causes microcephaly, microcephaly rates should be much higher where pyriproxyfen is used and much lower were the biological reagent is used (i.e didn't get the expected rates) results showed: microcephaly is equally likely with pyriproxyfen or biological larvicide. So pyriproxyfen does not cause microcephaly. there was no statistically significant difference
why is it important to keep public health statistics? We need them for monitoring disease nationally and internationally, and for prevention strategies
how can we try to prevent microcephaly caused by Zika? -mosquito control -pregnant women must avoid exposure to Zika -if Zika is transmitted between people, try reduce transmission -prioritize vaccine development
why does it matter if the disease is infectious or not? prevention methods etc will be different infectious diseases are harder to control due to spread if environmental: remove toxin = problem solved
how do you tell if a disease is infectious or not? if you suspect environmental exposure rather than infectious disease, compare phenotype in groups with and without exposure
can group B Strep cause meningitis? (GBS) yes
how can GBS cause meningitis? 1) Congenital - infection before birth (if GBS get into amnionic fluid) 2) Early onset - infection during delivery (inhalation - pneumonia or via umbilical cord) either of these can result in bloodstream infection/meningitis 3) Late onset (>1 week postnatal): rare! GBS from mother or someone else and meningitis common
how can we effectively prevent transmission to infants? could swab mothers to see if they are contaminant -screen for maternal colonisation and treat GBS positive mothers with penicillin during labour -neonatal intensive care measures successful in reducing mortality
define incidence number of new cases in a defined time period (%)
define prevalence number of new + existing cases in a time period (%)
define rate number of cases / total population (%)
define morbidity number of fatal + nonfatal cases (%)
define case fatality rate number of fatal cases / total cases (%)
define morbidity number of fatal cases / total population (%)
how are incidence, prevalence, morbidity and mortality similar and different? similar - may all be normalised by population, size and time different - what they are describing
define carriage / colonisation rate number carrying disease / number tested
define transmission rate number of exposed who are infected / total number exposed
define distribution how is an infectious disease distributed according to geography, season, SES, or other demographic parameters?
what public health branches receive information on notifiable diseases? "is this salmonella" public health officers medical practices
what do we do with data that goes to the public health branches? analyse mortality, morbidity, and other epi data to create policy: -how will we control the disease? -do we need to legislative changes? -do we need to increase surveillance?
draw a flowchart of the public health branches in NZ
When did Ignaz Semmelweis demonstrate that the incidence of puerperal fever could be reduced by washing hands with chlorinated solutions? 1847
When and what did John Snow discover? In 1854 he traced the source of an outbreak of cholera to a single point source
In what years did Louis Paster propose the germ theory of disease? 1860-1864
What years did Joseph Lister discover antiseptics? 1865-1867
When did Koch formulate his postulates 1884
When did Alexander Fleming discover Penicillin? 1928
what percent of mothers are asymptomatic 10-30%
Describe the cell morphology of group b strep Gram positive cocci in chains
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