Vbsc 444: Lecture 1 - History Of Epidemiology

Front 1

Define epidemiology.

Back 1

The study of the people: How is disease distributed, what are its determinants, and what is its population?

Front 2

What are the 3 components of epidemiology

Back 2

Distribution
Determinants
Population

Front 3

What are the 3 components of a disease's distribution?

Back 3

Person (age, sex, race, etc)
Place (location, proximity, clustering)
Time (date/time, seasonality)

Front 4

What is a disease's determinant?

Back 4

Any factor that influences health: physical agent, biological/cultural/behavioral factors, etc.

Front 5

What sorts of things are important to know about a given population?

Back 5

Size, age distribution, education, occupation, affluence, etc.

Front 6

What are the 5 specific objectives of epidemiology?

Back 6

1. Determe the cause, transmission mechanism, & risk factors of disease.
2. Determine the extent of a disease in a population.
3. Study the natural history, progression, & prognosis of a disease.
4. Develop new preventative/therapeutic measures.
5. Provide a foundation for public policy & regulatory decisions.

Front 7

What does determining the cause, transmission mechanism, & risk factors of disease allow us to do?

Back 7

Reduce/eliminate exposure to the disease's cause.
Gives a basis for prevention programs.

Front 8

What does determining the extent of a disease in a population allow us to do?

Back 8

Plan health services and properly train healthcare providers.

Front 9

What does studying the natural history, progression, & prognosis of a disease allow us to do?

Back 9

Develop new diagnosis and intervention methods.

Front 10

What does developing new preventative/therapeutic measures allow us to do?

Back 10

Determine the effectiveness of vaccines and education programs.

Front 11

What is the main difference between medicine and epidemiology?

Back 11

The size of the patient (one person in medicine, populations in epidemiology)

Front 12

What are the 4 phases of a disease's "natural history"?

Back 12

1. Pre-exposure: factors predisposing for disease.
2. Pre-clinical: disease processes occurring without symptoms.
3. Clinical: symptoms are present.
4. Resolution: recovery

Front 13

In what disease phases can primary prevention be used?

Back 13

1 and 2

Front 14

In what disease phases can secondary prevention be used?

Back 14

3

Front 15

In what disease phases can tertiary prevention be used?

Back 15

4

Front 16

What did Hippocrates contribute to epidemiology?

Back 16

The idea that:
- air, water, and location influences disease rate
- some diseases are seasonal, endemic, or epidemic

Front 17

When was the Black Plague?

Back 17

1347-1351

Front 18

Who discovered that the plague bacteria was found in both rats and infected humans, and when?

Back 18

Dr.s Yersin and Kitasato, 1894

Front 19

When was the rat flea's alternate-food seeking behavior in response to plague infection observed?

Back 19

1896

Front 20

When was the first plague vaccine made?

Back 20

1987

Front 21

When was cowpox first used to "vaccinate" against smallpox?

Back 21

1796

Front 22

When was the cholera epidemic analyzed by John Snow?

Back 22

1854

Front 23

What were John Snow's 3 theories of cholera epidemics?

Back 23

Epidemics follow routes of commerce
Agent is free-living and multiples within the host
Transmission is waterborne, spread via fecal contamination, ingested orally

Front 24

What 3 techniques, still used today, did John Snow use to analyze the cholera outbreak in 1854?

Back 24

Ecological analysis
Cohort analysis
Case control analysis

Front 25

What does ecological analysis examine?

Back 25

Rate of disease by region.

Front 26

What does cohort analysis examine?

Back 26

The rate of cases in exposed vs unexposed people.

Front 27

What does case control analysis examine?

Back 27

The exposure history of infected vs uninfected people.

Front 28

What did Ignaz Semmelweiss contribute to medicine, using rudimentary epidemiological observations??

Back 28

Handwashing/sanitation in hospitals, based on the observation that doctors coming from a rotation in cadaver dissection into maternity had higher rates of maternity patient death than midwives.

Front 29

When did germ theory arise?

Back 29

1882

Front 30

Who built germ theory, and on what two facts?

Back 30

Pasteur and Koch, germs are airborne, and cause specific diseases

Front 31

What are the 4 Koch postulates?

Back 31

1. The causative agent must be present in every case of the disease and must not be present in healthy animals.
2. The pathogen must be isolated from the diseased host animal and must be grown in pure culture.
3. The same disease must be produced when microbes from the pure culture are inoculated into healthy susceptible animals.
4. The same pathogen must be recoverable once again from this artificially infected animal and it must be able to be grown in pure culture.

Front 32

What did Richard Doll contribute to epidemiology?

Back 32

Linking smoking to lung cancer and heart disease using Chi-squares, yielding exact probabilities of the disease based on given factors.

Front 33

What is public health?

Back 33

The science of protecting and improving the health of the people.

Front 34

How is health being redefined?

Back 34

A state of complete physical/social/mental wellbeing.