Name:                                                                                                                                                  Homework Assignment #1                                                                 Due: September, 2014

S1-6: Below are 3 key terms taken from the definition of epidemiology followed by a list of activities that an epidemiologist might perform. Match the term to the activity that best describes it.

1. Distribution
2. Determinant
3. Application
4. Graph the prevalence of Chronic Hepatitis C infection by county for residents in Michigan_DISTRIBUTION
5. Recommend alerting hospitals and physicians to increase their awareness of the signs and symptoms of influenza after a novel strain of the virus emerged worldwide_APPLICATION
6. Compare the incidence of breast-feeding among mothers who are enrolled into the WIC program and mothers who are not_DETERMINANT
7. Propose testing the blood lead levels of all children less than 5 years old in zip codes in Genesee County with 40% or more of the houses built before the year 1950 based on previous research_APPLICATION
8. Calculate the frequency of influenza like illness cases, gastrointestinal illness cases, and absenteeism in Genesee County schools and childcare centers_ DISTRIBUTION
9. Compare the effect of education levels between smokers and non-smokers in Genesee County_ DETERMINANT

7& 8: Based on the following scenario, use the words “efficacious”and “effective” to fill in the blanks.

 

A class that educates expectant mothers about safe sleep habits for infants is very successful at reducing infant mortality. The class was held in Fenton, but attendance was low because many high risk mothers could not find transportation to the facility.

This program is            EFFICACIOUS        but not            EFFECTIVE             .

9-12: Using the Michigan Department of Community Health Emerging Infectious Diseases Website, describe the causation of infection with Lyme Disease in terms of agent, host, and environment (www.michigan.gov/emergingdiseases)

 

9. Clinical Illness –Lyme disease is a sickness that is caused by a spirochete bacterium also referred to as Borreliaburgdorferi. The disease is transferred to people and animals largely through the bite of the tick, Ixodesscapularis.

 

10. Agent:Spirochete Bacterium (Borreliaburgdorferi)

 

11. Host: The Black-legged ticks (Ixodesscapularis) are responsible for transmitting Lyme disease bacteria to humans.

 

12. Environment:Outdoors

 

13-19: Read the Histoplasmosis information available at the Centers for Disease Control and Prevention National Center for Zoonotic, Vector-Borne and Enteric Diseases (http://www.cdc.gov/nczved/divisions/dfbmd/diseases/histoplasmosis/technical.html). Describe the chain of infection by identifying the reservoir(s), portal(s) of exit, mode(s) of transmission, portal(s) of entry, and factors in host susceptibility. Please use complete sentences to describe this chain of infection. In your description include information about the following:

 

13. Clinical Illness – histoplasmosis is an infection or illness that is a resultant of infection by a fungus called histoplasma. The fungus predominantly resides in soil that contains large amounts of bird or bat droppings. Person who get infected by the fungi experience fever, fatigue and cough. A large number of the people who get histoplasmosis get well on their own without any medication, but in some people, such as those with a weakened immune system, the infection can become severe.

 

14. Reservoirs: The fungus that causes histoplasmosis is called It predominantly lives in the environment, principally in soil that contains large amounts of bird or bat droppings.

 

15. Portal of entry:people get histoplasmosis after breathing-in the microscopic fungal spores from the air. The spores of the causal organism become airborne after contaminated soil is disturbed, and when people breathe-in the spores they become at risk of developing histoplasmosis. Once the spores enter the lungs, the person’s body temperature allows the spores to transform into yeast. The yeast can the travel to the lymph nodes and thereafter can travel to any other part of the body through the bloodstream.

 

16. Portals of exit:the fungus has no known portals of exit.

 

17. Modes of transmission:there are no known modes of transmission. It cannot be spread from the lungs between individuals and animals. However, the infection can be transmitted through organ transplant with an infected organ but this rarely occurs.

 

18. Portals of entry:the causal organism predominantly enters the body through the Nose, through breathing of contaminated soil.

 

19. Factors in host susceptibility:any person can get histoplasmosis provided they have visited an area or location where the fungus histoplasma lives. However, particular groups of people are at a higher risk for developing the severe forms of the illness. These are infants, adults aged 55 and older and people who have weakened immune systems such as HIV/AIDS patient.

 

20 – 22: For each of the following situations identify whether it reflects endemic disease, pandemic disease, or epidemic disease.

 

20. In 2009 a novel strain of Influenza H1N1 originated in Mexico and spread worldwide eventually killing officially 18,000 people though unofficial estimates are much higher.________________________________ PANDEMIC

 

21. Twenty-three (23) cases of chickenpox occur within one month in the Swartz Creek school district. There are normally twenty-five cases reported in that district during the entire 9-month school year.

______________________________EPIDEMIC

 

22. Twelve cases of Chronic Hepatitis C are reported in August 2009, this is slightly higher than the average number of cases per month in Genesee County.

________________________________ENDEMIC

 

 

23 – 25: Based on the following scenarios complete the following true or false questions regarding the type of epidemic spread.

 

23. Sixty (60) cases of salmonellosis occurring over a 30 day period traced to a contaminated batch of peanut butter would be consistent with a point source epidemic.

____________TRUE____________________

 

24. Seventy (70) cases of 2009 H1N1 influenza diagnosed in Kent County in October, November and December of 2010 would be consistent with a point source epidemic. (Note: Influenza has an incubation period of 2 to 4 days and a duration of illness of 1 to 2 weeks)

_____________FALSE___________________

 

25. One hundred and twenty (120) cases of giardiasis are identified in residents of Grand Blanc during a period of 8 weeks. Cases occurring in the first two weeks were among children who attended a party at a water park and the cases occurring in the latter 6 weeks were among members of their household. This would be consistent with a propagated epidemic.

_________TRUE_______________________

 

26. Diseases that can be directly or indirectly transmitted from animals to humans are called:          Zoonotic Diseases     

27. Diseases that are spread via an intermediary arthropod species are called: Arthropod-Borne Diseases

 

28. Epidemics that involve multiple means of exposure (i.e. a common source as well as propagated are known as: Mixed Epidemic

 

 

 

For the following Identify if the following are examples of Active or Passive Immunity

 

29. Antibodies acquiredby an infant via Breast Milk- ________________ Passive Immunity

 

30. Antibodies acquired via vaccination _______________________Active Immunity

 

31. Antibodies acquired via natural infection __________________________ Active Immunity

 

32. Antibodies acquired via transfusion _________________________ Passive Immunity

 

 

33. You have just completed evaluating an intervention program designed to improve cardiovascular risk factors. You find that the program is efficacious but not effective. As a resource person, what would you tell the organization that is sponsoring the intervention?

(2 Points)

 

When a program is effective, it means that the program has been able to achieve the planed outcomes, goals and, or objectives that it purposed to achieve as a result of its undertaking, intervention or initiative under ordinary normal circumstances. Efficacy is the extent to which a specific intervention, procedure or program produces the desired effect under ideal conditions.

Therefore, in the context of the intervention program designed to improve cardiovascular risk factors, the program being efficacious means that the program under ideal conditions results to improved cardiovascular risk factors among the target population. However, its being non-effective means its not being able to result to an improvement in cardiovascular risk factors. I would tell the organization that there is a problem in the execution of the program, thus I would recommend to the sponsoring organization that they improve on the implementation of the program.

 

34. What are some public health reasons for assessing and monitoring the health of communities and populations at risk?

(2 Points)

 

The continual monitoring and assessing of the health of communities and populations at risk helps in the identification of health problems and consequently rapid response to address it. It also helps in prioritization.Monitoring and assessing the health of populations and communities at risk also assists in ensuring and assuring that the population have access to appropriate and cost effective care as well as health promotion and disease prevention services.

 

35. Discuss how the Germ Theory of Disease and Koch’s postulates contributed to the advancement of epidemiology? To what extent is the identification of specific agent factors a prerequisite for tracking down the cases of disease outbreaks? (2 Points)

 

The Germ Theory of Disease formed the first revolution in epidemiology by postulating that a particular micro-organism would be found responsible for any given disease. On the other hand, Koch’s Postulate provided absolute proof that a particular micro-organism caused a particular disease. It conclusively proved that a specific species of bacteria caused a specific human disease. That is, the causative microorganism must be present in every individual with the disease. Germ Theory of Disease and Koch’s postulates formed the best timed-test models for determining specific cause and effect of bacteria and they formed the foundation of modern epidemiology

 

The identification of a specific agent factor is critical in tracking down the cases of disease outbreak. This is for the reason that once a specific agent that causes a disease is identified, recurrence of the disease can appropriately be prevented by either killing the agent or the infected persons and non-infected persons can be isolated to prevent further spreading.

 

36. What are the characteristics that distinguish pandemic disease from epidemic disease? Name some examples of notorious pandemic that have occurred throughout history. Why did the “Spanish Flu” of 1918 qualify as a pandemic? In giving your answer, be sure to define and distinguish the terms: Epidemic, Endemic and Pandemic. (2 Points)

 

An epidemic is an increase above the expected level over a given time period of disease or health-related events in a defined population. It is an occurrence of cases in excess of what is normally expected in a community or region. When describing an epidemic, the time period, geographical region and particulars of the population in which the cases occur must be specified. An example of an epidemic in history is the rapid development of Kaposi Sarcoma, another manifestation of AIDS in New York in 1977 and 1978 and by 1982 there were 88 cases.

An endemic is the persistent, usual, or expected level of disease or health related events in a defined population. It is the constant presence of a disease or infectious agent within a given geographic area or population group. Therefore, endemic describes attributes of a disease, not an area.

A pandemic involves epidemics affecting a large number of people across many countries, continents, or regions. Examples of last century pandemics include Plague around 1900, influenza in 1918, 1957 and 1968, and Cholera since 1961.        Modern pandemics include HIV and multi-drug-resistant tuberculosis.

The Spanish flu of 1918 to 1919 qualified as a pandemic for the reason that it caused great loss of human population. It infected more than 500 million people worldwide first beginning in the United States, Europe and parts of Asia and thereafter swiftly spread all over the world. it killed approximately 20 million to 50 million. Thus it qualifies as a pandemic.

 

 
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