Epidemics and Pandemics

Lecture Day 1
 Epidemics and Pandemics

An epidemic is a disease that affects many individuals at once

Spreads rapidly via infection from one person to the next in an area where
the disease is not permanently or traditionally found
For example,
Black plague
Spanish flu (1918)
Yellow fever
AIDS
Small pox, mumps, measles

An epidemic becomes a pandemic when a very large number of people are
affected
Over a very wide geographic area—usually the entire globe
© 2013 by John Wiley & Sons, Inc. All rights reserved.
 Epidemiology
 Epidemiology is the application of the scientific method to the field of
disease
 Epidemiologists first observe the disease process, then they hypothesize the
origin of the disease and who is most susceptible
 Once they have an accepted hypothesis, they undertake a controlled
study, collect data, and analyze the results
 Methods used to study epidemics include case studies, case control
studies, cohort studies, and outbreak investigations
 Communication of these results is essential
 The goal of epidemiology is to stop the current epidemic and prevent its
return
© 2013 by John Wiley & Sons, Inc. All rights reserved.
 Case Studies
Case studies are in-depth analyses of the experiences of one
particular patient or a group of related patients
Case studies may lead to hypotheses about the cause or
treatment of a disease
A complete medical interview is part of every case study, and
it is usually carried out by a medical professional

© 2013 by John Wiley & Sons, Inc. All rights reserved.

 Case Control Studies
 Once a hypothesis is generated from the information gleaned from case
studies, a case control study may ensue
 In a case control study
 A group of patients with similar histories are solicited from the original
population
 All in this group are at a similar stage of the disease
 All are questioned about their contact with the original case studied
 Also are questioned about their history prior to and immediately after
showing symptoms of the disease
 Case control studies shed light on the method of infection, providing the
first real clues needed to halt the spread of the disease
© 2013 by John Wiley & Sons, Inc. All rights reserved.
 Cohort Studies
 Once the method of disease spreading is determined, a cohort study may
begin
 Participants are chosen from the infected area
 People should be disease and symptom free at the beginning of the study
 They should have a common element (i.e., smokers, postmenopausal
females, schoolteachers, college students, etc.)
 Participants are monitored for signs of the disease
 To estimate the likelihood of people within certain subpopulations getting
sick
 The sudden appearance of a disease in a small, localized group of people is
called an outbreak
© 2013 by John Wiley & Sons, Inc. All rights reserved.
 Error in Epidemiology
 It is difficult to group people into categories due to differences in physiology,
lifestyle, and socioeconomic level
 Those with more privileges may be able to afford better overall health care,
live in more sanitary environments, and eat healthier foods than those less
fortunate

 Other sources of error in epidemiology studies include

 Random error introduced due to sampling variability
 Systemic error due to using equipment with differing sensitivities or
technicians inaccurately recording the data collected
 Selection bias when participants are not chosen properly
© 2013 by John Wiley & Sons, Inc. All rights reserved.
 The World Health Organization
 Epidemics can cross borders

 Combating them requires international leadership

 The World Health Organization (WHO)

 A branch of the United Nations dedicated to helping people attain higher levels of
health
 Goals include providing medical care to rural populations and keeping tabs on
epidemics

© 2013 by John Wiley & Sons, Inc. All rights reserved.

The world Health Organization
 Dangerous Epidemics
 Some of the more dangerous epidemics
 Rift Valley fever
 Monkeypox
 Nipah virus
 HIV
 Flu, smallpox, polio, measles
 Tuberculosis, plague, and leprosy - bacterial diseases

 The best thing we can do to protect ourselves is wash our hands thoroughly
and often!

© 2013 by John Wiley & Sons, Inc. All rights reserved.

 The Disease Process
 Like all diseases, epidemics begin with a simple process
 The pathogen enters the human body (or host)
 It alters the physiology of the body to ensure its own survival
 Causing discomfort and possibly death as a result
 Entry into the host occurs through a specific mode of transmission
 For example,
 Physical contact with an infected person (ebola virus)
 Contact with airborne pathogenic particles (tuberculosis)
 Direct injection of the pathogen into the body (malaria, HIV)

© 2013 by John Wiley & Sons, Inc. All rights reserved.

 Effects of Pathogens
 Whether bacterial, viral, or protozoan in origin, many pathogens produce
toxins that cause illness
 Food poisoning, for example, is caused by toxins produced by the infecting
bacteria
 Age has an effect on the severity of any disease
 Very young people do not have a well-developed immune system to
combat illness, nor do they usually have the energy reserves to sustain
themselves through a prolonged illness
 The elderly also have a slower immune response and fewer reserves to
draw upon in times of crisis

© 2013 by John Wiley & Sons, Inc. All rights reserved.