EPIDEMIOLOGY

What is Epidemiology?
• the study of occurrences and distribution of diseases as well as
the determinants of health states or events in special
population, and the application of this study to the control of
health problems.
• The ultimate goals of epidemiology are to determine the scale
and nature of human health problems, identify solutions to
prevent disease, and improve the health of the entire
population.
• Is the backbone in diseaseprevention.
Uses of Epidemiology
According to Morris, uses of epidemiology include the ff:
1. Todiagnose the health of the community and the condition of the
people;
2. Tomeasure the distribution and dimension of illness in terms of
incidence, prevalence, disability andmortality;
3. Toset health problems in perspective and to define their relative
importance;
4. And to identify groups needing special attention. - New methods of
monitoring must be constantlysought.
5. Tostudy the history of the health populations and the rise and fall of
disease and changes in their character.
Uses of Epidemiology
6. Tostudy the working of health services with a view of
improving them.
7. Toestimate the risks of diseases, accident, defect and the chances of
avoiding them.
8. Tocomplete the clinical picture of chronic disease and describetheir
natural history.
9. Toidentify syndromes by describing the distribution and
association of clinical phenomena in thepopulation.
10. Tosearch for causes of health and disease by comparing the
experience of groups that are clearly defined by their
composition, inheritance, experience, behavior andenvironments.
Outline of Plan for Epidemiological
Investigation
1.Establish fact of presence of Epidemic
• Verify diagnosis
• Reporting
• Is there an unusual prevalence of thedisease
• Identify if it is the disease which it is reported to be
2.Establish time and space relationship of the disease
• Are the cases limited to or concentrated in any particular
geographical subdivision of the affected community? Relation of cases by
days of onset to onset of the first known cases-may be done by days,
weeks or months (in general, by weeks gives best overallpicture).
Outline of Plan for Epidemiological
Investigation
3. Relations to characteristic of the group of community:
• Relation of cases toage groups, sex, color, occupation,
school attendance, past immunization,etc.
• Relation of sanitary facilities, especially water supply,
sewerage disposal, general sanitation of homes, and relation
to animal or insectvectors.
• Relation to milk and food supply.
• Casesand known relation of cases to other carriers if any.
Outline of Plan for Epidemiological
Investigation
4. Correlation of all data obtained
• Summarize data clearly with the aid of such tables and
charts are necessary to give a clear picture of the situation.
• Build up the case for the final conclusion carefully utilizing
all the evidenceavailable.
• Establish the source of the epidemic and the manner of the
spread, if possible.
• Make suggestions as to the control, if disease is still present
in community and as toprevent future outbreaks.
Natural Life History of the Disease
• This process involves the interactions among a
susceptible host, the causative agent and the
environment (Valanis, 1999)
The four stages (Valanis, 1999) are susceptibility,
adaptation, early pathogenesis and clinicaldisease.
Epidemiological Triangle
The triangle has three corners (called
vertices):
• Agent – or microbe thatcauses the
disease (the “WHAT” of the triangle) HOST
• Host – or organism harboring the disease
(the “WHO” of the triangle)
•Environment – those external factors
that cause or allow disease transmission
(the “WHERE” ofthe triangle)
The mission of the epidemiologist is to
break at least one of the side of the
triangle, disrupting the connection
between the environment, the host and the
agent, and stopping the continuation of
disease. AGENT ENVIRONMENT
THEEPIDEMIOLOGICALAPPROACH
The phases of epidemiologic approach consistof:

1.Descriptive Epidemiology – concerned with disease distribution and

frequency
2.Analytical Epidemiology – attempts to analyze the causes or
determinants of disease through hypothesistesting
3.Intervention or Experimental Epidemiology – answers questions
about the effectiveness of new methods for controlling diseases or for
improving underlying conditions.
4.Evaluative Epidemiology – attempts to measure the effectiveness of
different health services andprograms.
Immunity
• A host’s ability to resist a particular infectious
disease causing agent; the body forms antibodies
and lymphocytes that react with foreign molecules
and render them harmless.
Types of Immunity
1. Passive Immunity: short term resistance that is acquired either
naturally or artificially (newborns through maternal antibody &
inoculation with antibody products to provide temporary resistance)
2. Active Immunity: long term/lifelong resistance that is acquired
either naturally (thru host infection) or artificially (vaccinations)
3. Cross Immunity: a situation in which person’s immunity to one
agent provides immunity to a related agent (passive or active); BCG
vaccine helps prevent TBto people who have been exposed to
leprosy
4. Herd Immunity: the immunity level present in a population group
(mandatory preschool immunizations and required travel
vaccinations)
Four Stages of Diseases
1.Susceptibility Stage: the disease is not present and
individuals have not beenexposed
2.Subclinical Disease Stage: begins when individuals have
been exposed to a disease but areasymptomatic
3.Clinical Disease Stage: signs and symptoms of the disease
or condition develop (lab tests, acutesymptoms)
4.Resolution Stage: the disease or health condition causes
sufficient anatomic or functional changes to produce
recognizable signs and symptoms
FUNCTIONSOFTHENURSEINEPIDEMIOLOGY
• Maintain surveillance of the occurrence of notifiable diseases.
• Coordinate with other members of the team during outbreak.
• Participate in case-finding and supervising care.
• Isolate cases ofcommunicable diseases.
• Render nursing care, teach and supervise giving of care.
• Perform and teach household members regarding concurrent and terminal disinfection.
• Give health teaching to prevent further spread of disease to individuals and families.
• Follow up cases andcontacts.
• Organize, coordinate and conduct community health education campaigns.
• Refer cases when necessary.
• Coordinate with other concerned community agencies.
• Accomplish and keep records and reports and submit to proper office/agency.
Epidemiological Process and Investigation
– is a systematic course of action taken to identify:
• Who were affected.
• Where the affected personsreside.
• When the affected persons wereaffected.
• Causal factors of health and diseaseoccurrence.
• Prevalence and incidence of health and disease.
• Prevention and control measures in relation tothe
natural life history of a disease or a condition.
Epidemiologic Research includes SevenSteps:
1. Identify the problems which is usually a threat to the
population’s health.
2. Review the literature to determine what other studies have
found.
3. Carefully designs the study.
4. Collect the data.
5.Analyze the findings.
6.Develop conclusions and applications.
7. Disseminate the findings.
Patterns of Disease Occurrence:
1. Epidemic
➢Exists when there are more cases of a particular disease than expected in a
given area, or among a specific group of people, over a particular period of time.
➢Asituation when there is a high incidence of new cases of a specific disease in
excess of the expected.
➢When the proportion of the susceptible are high compared to the proportion of
the immunes.
➢Example: Outbreak of H1N1,SARS
Epidemic Potential
➢An area becomes vulnerable to a disease upsurge due to causal factors such as
climatic changes, ecologic changes, or socio-economicchanges.
Patterns of Disease Occurrence:
2. Endemic
➢Habitual presence of a disease in a given geographic location accounting for the
low number of both immunes and susceptible. The causative factor of the disease
is constantly available or present to thearea.
➢ Exists when a population has a high level of the disease all the time
➢Example: Dengue in Cebu and Malaria inPalawan
3. Sporadic
➢Disease occurs every now and then affecting only a small number of people
relative to the totalpopulation.
➢Is the intermittent occurrence of a few isolated and unrelated causes in a given
locality. It is
➢ Seasonal or periodic.
Patterns of Disease Occurrence:
4. Pandemic
➢Exists when there is a simultaneous occurrence of
epidemics of the same disease in several countries
of international perspective.
➢Global occurrence of a disease.
➢Example: COVID19