EPIDEMEOLOGY

LECUTRE

Epidemiology: the field of medicine that studies the incidence of disease, the distribution of
disease in a population, the causes of disease, and the prevention or control of disease incidence.

How the flu spreads

● We can project respiratory droplets up to 20 feet
● We inhale those droplets when we breathe
● Flu can remain infectious on surfaces for up to 24 hours

Flu symptoms
● Fever
● Chills
● Cough
● Body aches
● Symptoms begin 1-2 days after someone is infectious
● Symptoms last 5-7 days

Flu subtypes
● Influenza A
● Influenza B
● Influenza C (causes mild illness)
● Influenza D (does not affect humans)

Flu strains and lineages

● Influenza A subtypes are further divided into different strains: H1N1, H3N2
● Influenza B is also divided into strains and lineages: B/Yamagata, B/Victoria

Flu epidemiology
● Attack rate of 8-9% (out of 100 people exposed, 8-9 get flu)
● Basic reproduction number of 1-2 (# of secondary cases for every primary case, someone who
gets the flu will infect 1-2 additional people)
● Seasonal flu: Attack rate of 7-8; R0 of 1.27
● Pandemic flu: Attack rate of 20-50; R0 of 1.8
● How quickly a virus spreads on several factors, including characteristics of the virus and of the
infected hosts

Flu-watch
● Older adults typically account for 54-70% of flu cases and 71-85% of flu deaths
● Number of elderly is increasing, high risk population is growing
● Other vulnerable groups:
○ Pregnant women
○ Children under 5
○ People with chronic medical conditions
○ People with immunosuppressive conditions
○ Health care workers and caregivers

There are a few aspects of infections in aging populations that we should consider:
● Immunosenescence: the immune system works less well as we age
● vaccines become less effective over the age of 65
● increased use of antibiotics in treating infections, leading to antibiotic resistance
● increased exposure to high risk environments, including hospitals

Flu vaccine in older adults

● As one ages, vaccines are less effective
● Alternate vaccines higher in strength are made for them
● High-dose vaccine (Fluzone) contains four times the amount of antigen as the regular shot
● Adjuvanted flu vaccine (Fluad) elicits a stronger immune response than the regular shot
● People 65 years and older should not get the nasal spray vaccine, the intradermal shot or the jet
injector vaccine

Ways to limit flu spread

● Avoid close contact with sick people
● If you’re sick, avoid contact with others
● Antiviral drugs can lesson symptoms and accelerate recovery
● Wash hands often and thoroughly
● Avoid touching your eyes, nose or mouth
● Cough and sneeze into your arm or a tissue
● Clean and disinfect surfaces and objects that may be contaminated
EPIDEMIOLOGY

● 65+ = 18% of canada’s population

● 2041 -- 24% of the population will be 65+
● Two medical practices profoundly impact infectious disease rates: the use of antibiotics and
vaccines -- this is why canada has so many old people
● Deaths because of influenza and pneumonia rank higher in younger (1-14) and older (65+)
generations.
● Aspects of infections in aging populations
○ Immunosenescence: old people immune system sucks
○ Vaccines: less effective
○ Increased use of antibiotics in treating infections
○ Increase exposure to high risk environments for contracting influenza (i.e, hospitals)
● Epidemiology: the field of medicine that studies the incidence of disease, the distribution of
disease, the cause of disease and the prevention/control of disease