1. Ch Epidemiology
Microbiology

2. 10.3 Predisposing Factors
Anatomical-UTI
Genetic-Cystic fibrosis
Disease specific
Climate & Weather
Overall health
Age
Diet

3. 10.3 Disease Development Stage 1: Incubation period
Stage 2: Prodromal period
Stage 3: Acute period
Stage 4: Convalescence period

4. 10.3 Disease Reservoirs
Animals are natural reservoirs for many diseases
Plague-rodents
Chagas-armadillos
Babeiosis-ticks
Rabies-raccoons, skunks, bats
Cholera-shellfish
SARS-bats
Ebola-bats, primates
Human reservoir
Non-living reservoir

5. 10.3 Infectious Disease Transmission
Direct contact
Indirect contact
Aerosolized-air
Food & water contamination
Fomite-objects
Vector-animal carriers

6. 10.3 Ecology, Epidemiology & Evolution of Pathogens
Zoonose-disease transmitted between different species.
Ecological competence- ability of a pathogen to survive and compete
Virulence-the degree of pathogenicity, fatality rates.

7. 10.3 Safety in the Microbiology Laboratory
Center for Disease Control (CDC) biohazard levels 1-4
BSL1 Minimum risk, normal protection: gloves, goggles
BSL 2 Bacteria & viruses that cause treatable disease, non- aerosol. Lab bench required
BSL3 Severe to fatal diseases, but vaccines exist. Sealed containers with gloves, positive air flow.
BSL 4 No vaccines or treatment, positive-pressure suit mandatory

8. 10.3 Finding Patient Zero & Tracking Diseases
Index case-patient zero
Typhoid Mary NYC Cook, infected 51 people, nearly 30 years of isolation
HIV-1970’s Gaetan Dugas flight attendant. Later determined that he was one of several responsible.
Ebola-2 year old boy in Guinea died 12/2/2013 bitten by a fruit bat

9. 10.4 Microorganisms in the Hospital
Hospital-acquired infections (HAI), nosocomial
In U.S. 1.7 million/year, 99,000 deaths
Ventilator-associated pneumonia
UTI
Staphylococcus aureus
Methicillin resistant Staph. aureus (MRSA)
Tuberculosis
Legionnaires’ disease
Hospital-acquired pneumonia (HAP)-most common cause of death

10. 10.4 Chain of Transmission
Gram-negative resistant bacteria can survive a long time on surfaces.
Enter body through wounds and devices.
Airborne: Legionella, TB, rubeola & varicella viruses.
Poor sanitation practices by medical personnel is a major cause of infection.
All medical personnel must follow proper sanitation protocols including: washing, sterilization and personal protection equipment (PPE).

11. 10.5 Descriptive Epidemiology
Calculation of risk factors based upon data; time, place & people.
Age
Education
Socioeconomic status
Availability of health services
Race
Gender
Drug abuse
Sexual promiscuity
Diet
Exercise

12. 10.5 Analytical Epidemiology
Statistical inferences based upon causes of disease in populations using sampling.
Focuses on genetic and environmental factors that cause disease.

13. 10.5 Experimental Epidemiology
Uses an experimental model to confirm causal relationship suggested by observational studies.
Three case types:
Randomized control trial
New medicine, drug testing
Field trial
High risk groups
Community trial
Social diseases

14. 10.5 Public Health Local governmental programs to promote good health.
Focus on prevention of disease.
Hygiene
Breastfeeding
Diet
Exercise
Vaccination
Planned parenthood
Drug abuse rehabilitation

15. 10.5 Global Health
Epidemiological, medical, economic & political approaches.
World Health Organization (WHO)
UNICEF
World Food Programme (WPF)
United Nations (UN)
World Bank
Doctors Without Borders

16. 10.5 Emerging and Reemerging Diseases
Incidence increase in the last 20 years.
12% of all human pathogens.
SARS
HIV/AIDS
Influenza
West Nile
Lyme disease
Tuberculosis
Ebola
Zika

17. 10.5 Biological Weapons Biological Warfare (BW)
Banned by 1972 Biological Weapons Convention
Smallpox
Plague
Tularemia
Anthrax
Brucellosis
Botulism

18. 10.5 Technology & New Infectious Agents
Molecular Techniques are much faster and more accurate at identifying diseases.
Treatment development and communication have accelerated.
Overpopulation, industrial agriculture and ecosystem destruction are causing more diseases.
Modern transportation greatly accelerates the scope and spread of diseases worldwide.

19. 10.5 Current Pandemics Influenza
3 Pandemics in 20th century killed tens of millions
Spanish Flu million deaths
Avian Flu (H5N1) 700 cases 60% mortality rate
Swine Flu (H1N1) 17,000 deaths
HIV/AIDS 1981-today, about 70 million infected and 35 million dead
Ebola , over 28,000 infected and 11,000 deaths
Zika , 1.5 million infected, 3,500 microcephaly