By: Dr. Asmaa Sayed Ahmed Ph.D.

Microbiology (Microbiology) for second stage

Introduction to Epidemiology
The Greek physician Hippocrates is sometimes said to be the father of
epidemiology. He is the first person known to have examined the relationships
between the occurrence of disease and environmental influences.

 Epi – means “on, upon, befall”

 demo – means “people, population, man”
 logy – means study

Definition of Epidemiology:- The study of frequency, distribution and

determinants of diseases.

The constant presence of disease within a geographic area or the usual prevalence
of a given disease in a particular area. Malaria, Tuberculosis, etc. Pandemic: (pan =
all: demos = people) An epidemic which spreads from country to country or over the
whole world, as for example, the recent epidemic of AIDS.

Aims of Epidemiology
To describe the distribution and size of disease problems in human population. To
identify etiological factors in the pathogenesis of disease. To provide data essential to the
planning, implementation, and evaluation of services for the prevention, control and
treatment disease and to setting up the priorities among these services.

Uses of Epidemiology

•To study the effects of disease state in a population over a time and predict future health.
•To diagnose the health of the community.
•To evaluate health services.
•To estimate the individual risk from group experiences.
•To identify the syndrome.
•To search for causes of disease.

Levels of Prevention
 Primary prevention Health promotion Specific protection
 Secondary prevention Early diagnosis (screening tests, case finding
programmers ) Adequate treatment ,
 Tertiary prevention Disability limitation Rehabilitation – Functional,
Vocational , Social , Psychological rehabilitation)

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By: Dr. Asmaa Sayed Ahmed Ph.D. Microbiology (Microbiology) for second stage

Epidemiological approach
1. Asking questions
2. Making comparisons
1. Asking questions Epidemiology has been defined as a means of learning or asking
questions.. and getting answers that lead to further questions RELATED TO
HEALTH EVENTS What is the event? (the problem) ,Where did it happen? ,When
did it happen? ,Who are affected? ,Why did it happen?

Source of Infection

Vehicles of transmission

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By: Dr. Asmaa Sayed Ahmed Ph.D. Microbiology (Microbiology) for second stage

Control of Epidemic Disease

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By: Dr. Asmaa Sayed Ahmed Ph.D. Microbiology (Microbiology) for second stage

Normal Flora for human body

many organs and sites in the healthy human host are free of microorganisms.
These include the cerebrospinal fluid, blood, urinary bladder, uterus, fallopian tubes,
middle ear, paranasal sinuses and kidneys. It is estimated that the adult human body is
host to at least 100 trillion microbial cells at any time.

Normal Flora -indigenous microorganisms, most of which are bacteria -they inhabit
the skin and some of the inner surfaces of the body (such as the skin, mouth,
nasopharynx, ears, intestinal tract, and lower urogenital tract) -sex of the host may
also influence the composition of the normal microbial flora.

species, no. of normal flora sometimes depends at particular ages of the host. -
members of the normal flora may also be thought of as the resident flora (those
microbes regularly found in a given site at particular host age). -are harmless they do
not cause disease unless they become opportunistic pathogens (which cause infections
if tissue injury occurs at specific body sites or if the resistance of the body to infection
is decreased)

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By: Dr. Asmaa Sayed Ahmed Ph.D. Microbiology (Microbiology) for second stage

Various Factors affect the nature and extent of the normal flora:
1. weather (T & humidity, density of skin microflora)
2. age has an effect (young children has more varied microflora and carry more G-
bacteria, potential pathogens than adults)
3. hospitalized patients (> no. Of pathogens and antibiotic- resistance organisms than
normal people)
4. personal hygienic habits influence the resident microflora and unclean individuals
have higher population densities)

Transient flora :- simply harbored for a short time by the human body -may be
present only for several hours, days, or weeks, and then disappear

Distribution and Occurrence of the Normal Flora

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By: Dr. Asmaa Sayed Ahmed Ph.D. Microbiology (Microbiology) for second stage

1. Blood, Body fluids, and tissues -occasional microbes may cross protective
epithelial barriers as a result of trauma
2. Skin -1st line of defense -several factors responsible for discouraging microbial
growth on the skin:
a. Dryness -102 to 104 bacteria per square centimeter
b. Low pH- between pH 3 to 5
c. Inhibitory substances- eg. Sweat glands (lysozyme-enzyme that destroy the
peptidoglycan of bacterial cell walls) -sebaceous glands- secretes complex
lipids which may be partially degraded by bacteria such as Propioni bacterium
acnes to produce long-chain fatty acids, such as oleic acid (highly inhibitory to
other bacteria)

3. Eye – has conjunctiva(membrane lining the eyelids which continually washed by

a flow of tears-tends to remove microorganisms (has lysozyme)
4. Respiratory tract a. Upper respiratory tract b. lower respiratory tract
5. Mouth- S. mutans (produces glucan that is formed only in the presence of sucrose)
Dental plaque - aggregation of bacteria and organic matter on the surface of the
teeth. -contains a very high number of bacteria, 108 cells per milligram
6. Gastrointestinal tract a. Stomach b. small intestine c. large intestine- has the
largest microbial popn
7. Genitourinary tract