1. Chapter 32 Epidemiology the Core Understanding of Public Health

2. Epidemiology: Study of Disease Occurrence, Distribution and Determinants of Health Infectious Disease Death Rates, USA

3. Clicker Questions:

5. Epidemic vs Endemic … Dots on A Map

6. John Snow – First Epidemiologist Cholera Outbreak, London 1854

7. The Pump, The Pub

9. Who, When Where … Tracking Disease Pattern Prevalence = (Total # cases in a pop)/Total people x 100% Incidence = (# New Cases)/(# Susceptible People) Usually based on 100,000 people Centers for Disease Control, Atlanta Morbidity and Mortality Weekly Report Epidemiology

10. Morbidity and Mortality Weekly Report

11. Clinical Stages of Disease Classical Symptoms Here

12. Incubation Periods

15. Some diseases are transmitted by active carriers: a pathogen infected individual who has had the disease and recovered, but continues to carry and spread the pathogen

16. Incidence of California Encephalitis Clicker Question:

17. Types of Epidemics by Incidence

18. Co-Evolution of Host/Pathogen: The Australian Rabbit and Myxoma Virus Experiment Clicker Question:

19. Herd Immunity

20. The USA AIDS Eipdemic

22. HIV Infects Both Sexes

23. Nosocomial Infections

28. Causes of Death: Africa and Americas Clicker Question

30. Emerging and Re-emerging Infectious Diseases

36. Small Pox: The Eradicated Disease? Clicker Question:

37. Small Pox: The Eradicated Disease? Clicker Question Follow Up:

38. Planned Bioterrorist Attacks 1984: A group sprayed salad bars in The Dalles, Oregon with Salmonella enterica Tiphimuriuim causing 751 salmonellosis cases. 1995: Sarin (neurotoxic gas) sprayed in Tokyo subway, killed several people. Since 1995: Most common are Bacillus anthracis spores: sprays, in letters, etc.

39. Bacillus anthracis causes Anthrax Clicker Question:

40. Bacillus anthracis causes Anthrax Clicker Question:

41. The Three Forms of Anthrax Cutaneous Anthrax Pulmonary Anthrax 1.Cutaneous Anthrax (skin hemorrhage) 2.Pulmonary Anthrax (lung and cerebral hemorrhage; fatality rates at ~90% plus) 3.Gastrointestinal Anthrax (rare)

42. Anthrax: 2 Toxins, 3 Proteins PA Protective Antigen LF Lethal Factor EF Edema Factor _____________________________________________________ PA-LF Lethal Toxin (cytotoxin) PA-EF Edema Toxin Clicker Question:

43. Weaponized Anthrax Spores Endospores mixed with talc powder: in mailed envelopes or packages to news media (Florida), government (Washington DC), non-focused in Pennsylvania, New Jersey, New York.  22 cases of Anthrax: 11 cutaneous + 11 pulmonary  5 Deaths Bioterroist was a bioweapons lab worker. Bioweapon facility in Sverdlovsk, Russia: inadvertant release of 1 gram of endospores  77 anthrax cases, 66 died.

44. Anthrax Vaccination - Treatment Incubation Period: at least 8 days 1.treatment with Ciprofloxacin prophylactically to exposed persons. 2.Vaccine: AVA Anthrax Vaccine Absorbed : prepared from cell-free culture filtrate. 3.Clicker Question: