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Epidemiology & Public Health I. Descriptive Terms A. ____________________ – Study of frequency and distribution of diseases. 1. World’s Population a. Crowding b. Social Unrest c. rapid transportation of diseases d. Mass distribution of food & supplies that may contain pathogens. B. ___________ – Disease that are constantly present in a given population. C. ___________ – Usually large number of cases in a population. (Flu & Pneumonia). D. ___________ – Fraction of people who have the disease in a given population. (100 people out of 5,000: City) (100 people out of 1,000:Rural) E. ___________– Number of cases developing the out of 100 people exposed. F. ___________– Number of cases divided by the population at risk. (Flu is increasing) G. ___________– Number of cases dying from the disease. (AIDS, Ebola is increasing) H. ___________– Number of new cases in a specific time period in a given population. I. ___________– Total number of existing cases in a given population. J. Communicable Disease – Diseases that can be transmitted from person to person (Flu, measles). K. ___________ Non transmitted. (Pneumonia-inhalation of normal flora). L. ___________– Subsides rapidly – Flu M. ___________– Symptoms persists (Maybe for years) 1 ___________– have symptoms 2. ___________ – no symptoms N. ___________ – remains inactive for a period of time. (cold sore). II. Spread of Diseases A. Requirements 1. Suitable ___________ to live & multiply. 2. Mode of ___________ to next host. 3. Appropriate ___________ to enter new host. B. Reservoir ___________ or source of an organism a. ___________ – Salmonella b. ___________ - Rabies c. ___________ l - Botulism, Tetani C. Carrier ___________ people and ___________ the disease a. Short term b. Chronic D. ___________ Disease Transmitted to humans by ___________ - Rabies E. How can disease spread 1. ___________ Transmission a. ___________ in environment – Syphilis – close intimate contact. b. ___________– Infectious dose- Shigella – only 100 c. ___________– less than 1 meter 1. ___________, coughing, ___________, singing 2. ___________– schools, barracks beds & desks are more then 4 ft apart (810) 3. ___________ 4. ___________– Mother to newborn – Syphilis, Rubella, Herpes 2. ___________ ___________ a. Passing through an ___________ object (___________). Clothing, tabletops. Doorknobs 3. ___________ or ___________– Infect the GI tract 4. ___________ a. ___________– 1 or 2 microorganism in a small droplet. b. May stay ___________ ___________. c. ___________(skin cells) d. Usual Conditions 1. ___________ - good ventilation, except highly infectious agents (chicken pox, measles). 2. ___________ – bad because of movements pumps air around. 3. ____ – Pathogens may grow in AC water & spread when turned on. 4. Difficult to control 5. ___________ a. ___________, ___________, b. ___________ – insect control 6. ___________– may determine the outcomes of the disease. a. ___________ bladder infection, no GI infection if ingested. b. ___________ – hand shake- only infect if ingested. Respiratory – coughing – inhaled c. ___________ (injection) - fleas, rodents Bubonic plague – lymph 7. Other influencing Factors a. ___________ {Period – length of time to exposure to tie of symptoms 1. AIDS –long 2. Typhoid Fever – exposed to drinking water b. ___________– small vs large amounts 1. typhoid Fever – 1,000,000 for symptoms c. ___________ – Prior exposure 1. Herd immunity – majority of population has immunity – non immune protected. d. ___________, ___________, ___________ e. ___________ 1. ___________ may be by ___________ – Africans immune to malaria because RBC’s lack receptors. f. ___________ III. Infectious Disease Surveillance A. ___________ 1. ___________ 2. ___________ 3. ___________–Morbidity & Mortality Weekly Report (MMRW) 4. Reports ___________ a. 52 new diseases 1. Malaria 2. Aids 5. ___________ a. TB b. Chicken Pox c. Measles d. Mumps B. ___________ 1. Health Labs, Public School, Hospitals 2. Report disease back to the CDC C. ______________________– WHO 1. Targets disease for eradication IV. Infectious Disease Control A. ___________ B. ___________– Hot bed for contagious diseases 1. Young children- little ___________ 2. Updates on ___________ 3. ___________ & ___________ Trained Staff C. Hospital 1. ______________________– Infection during hospitalization a. ___________- 1 million cases = 6 Billion dollars/yr. b. Hospital population is ___________ c. Bacteria by accident 1. ___________ 2. Open wounds - ___________ 3. ___________cleaned tools 2. Maybe ___________ by the staff. 3. ___________drug resistance The Progress of an Infection A. Pathogenicity 1. _______ or opportunistic pathogens 2. ________ and virulence factors B. Step one -Becoming __________ Portals of entry C. Step Two - ____________ to the host 1. How pathogens attach (___________). D. Step three - ______________ host defenses 1. How microbes escape phagocytosis a. __________________ b. ___________or ________ formation c. Survival ________ phagocytes after ingestion Establishment of Infection In order to cause disease pathogen must follow a series of steps __________________ __________________ Delivery of _______________ molecules Establishment of Infection Adherence Pathogen must adhere to host cells to establish infection Bacteria use _________ Often located at the top of ______ or _______ Binding of __________ to host cells receptors is highly specific Often _____________ type of cell to which bacteria can attach Establishment of Infection Colonization Organism must _________ in order to colonize New organisms must ___________ with established organisms for nutrients and space New organism must also overcome _______________ products produced by existing organisms as well as host immune responses Microbes have developed counterstrategies including rapid turnover of pili Some organisms produce iron-binding molecules called ___________________ Compete with host proteins for circulating iron Establishment of Infection Delivery of effector molecules to host cells After colonization some bacteria are able to deliver molecules _____________ to host Induce changes to recipient cell that include _________ of microvilli _________ uptake of bacterial cell. Causing disease 1. How virulence factors contribute to tissue damage a. Extracellular enzymes (exoenzymes) i. ____________ ii. ____________ iii. ____________ v. ____________; ____________ b. Bacterial toxins: A potent source of cellular damage i. ____________ ii. ____________ iii. ____________ iv. ____________ v. ____________ vi. ____________ c. Inducing an injurious host response Principles of Infectious Disease Distribution of pathogen Infections often described according to distribution within the body ____________ Infection limited to small area Example: boil ____________ or generalized Agent has spread or disseminated throughout the body Example:measles ____________ Toxins circulating in blood ____________ Viruses circulating in blood ____________ Acute life-threatening illness causes by infectious agent or their products circulating in blood Signs and symptoms: Warning signals of disease 1. Sign 2. Symptom 3. Syndrome 4. Signs and symptoms of inflammation a. ____________ b. Granulomas and ____________ c. Lymphadenitis d. ____________ e. Lesion 5. Signs of infection in the blood a. ____________ b. Leukopenia c. Septicemia____________that go unnoticed a. ____________ b. ____________ or inapparent Swine Flu Brochures Title page, picture. What is H1N1. How does it spread. How long can an infected person spread the viruses? Signs and symptoms of swine flu. What to do if you get H1N1. What to do to protect yourself from getting the H1N1. Warning signs for both children and adults. Treatment for H1N1. How long can the H1N1 remain of objects (doorknobs, keyboards, desks, books, etc…). Site sources and places to get more information about swine flu.