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Learning objectives

  • Explain the difference between prevalence and incidence of disease
  • Distinguish the characteristics of sporadic, endemic, epidemic, and pandemic diseases
  • Explain the use of Koch’s postulates and their modifications to determine the etiology of disease
  • Explain the relationship between epidemiology and public health

Part 1

In late November and early December, a hospital in western Florida started to see a spike in the number of cases of acute gastroenteritis -like symptoms. Patients began arriving at the emergency department complaining of excessive bouts of emesis (vomiting) and diarrhea (with no blood in the stool). They also complained of abdominal pain and cramping, and most were severely dehydrated. Alarmed by the number of cases, hospital staff made some calls and learned that other regional hospitals were also seeing 10 to 20 similar cases per day.

  • What are some possible causes of this outbreak?
  • In what ways could these cases be linked, and how could any suspected links be confirmed?

Jump to the next Clinical Focus box.

The field of epidemiology concerns the geographical distribution and timing of infectious disease occurrences and how they are transmitted and maintained in nature, with the goal of recognizing and controlling outbreaks. The science of epidemiology includes etiology (the study of the causes of disease) and investigation of disease transmission (mechanisms by which a disease is spread).

Analyzing disease in a population

Epidemiological analyses are always carried out with reference to a population, which is the group of individuals that are at risk for the disease or condition. The population can be defined geographically, but if only a portion of the individuals in that area are susceptible, additional criteria may be required. Susceptible individuals may be defined by particular behaviors, such as intravenous drug use, owning particular pets, or membership in an institution, such as a college. Being able to define the population is important because most measures of interest in epidemiology are made with reference to the size of the population.

The state of being diseased is called morbidity . Morbidity in a population can be expressed in a few different ways. Morbidity or total morbidity is expressed in numbers of individuals without reference to the size of the population. The morbidity rate can be expressed as the number of diseased individuals out of a standard number of individuals in the population, such as 100,000, or as a percent of the population.

There are two aspects of morbidity that are relevant to an epidemiologist: a disease’s prevalence and its incidence . Prevalence is the number, or proportion, of individuals with a particular illness in a given population at a point in time. For example, the Centers for Disease Control and Prevention (CDC) estimated that in 2012, there were about 1.2 million people 13 years and older with an active human immunodeficiency virus ( HIV ) infection. Expressed as a proportion, or rate, this is a prevalence of 467 infected persons per 100,000 in the population. H. Irene Hall, Qian An, Tian Tang, Ruiguang Song, Mi Chen, Timothy Green, and Jian Kang. “Prevalence of Diagnosed and Undiagnosed HIV Infection—United States, 2008–2012.” Morbidity and Mortality Weekly Report 64, no. 24 (2015): 657–662. On the other hand, incidence is the number or proportion of new cases in a period of time. For the same year and population, the CDC estimates that there were 43,165 newly diagnosed cases of HIV infection, which is an incidence of 13.7 new cases per 100,000 in the population. Centers for Disease Control and Prevention. “Diagnoses of HIV Infection in the United States and Dependent Areas, 2014.” HIV Surveillance Report 26 (2015). The relationship between incidence and prevalence can be seen in [link] . For a chronic disease like HIV infection, prevalence will generally be higher than incidence because it represents the cumulative number of new cases over many years minus the number of cases that are no longer active (e.g., because the patient died or was cured).

Questions & Answers

what is mutation
Cynthia Reply
alteration in genetic makeup
UDEME
Hi, I'm new here. I'm Bello Abdul Hakeem from Nigeria.
BELLO Reply
welcome on board
Kamaluddeen
Thanks brother I'm an undergraduate. I hope to study for MBBS.
BELLO
pls guys help me out
Linda
what is limitation of plate
Linda
limitation of plate load test . there are some that should be considered while performing load test which are given below, this test is usually performed on relatively similar plate ,usually 1 or 2 square foot area the reason is that the plate of greater are the economically not feasible
yemi
Mechanism of bacterial pathogenicity
rashida Reply
Toxicity
Ibrahim
write a short note on Algea
najaatu Reply
green minutes plants organisms that are produced in turf.
Prince
Algae is a kind of a photosynthetic organism, which is usually grown in the moist areas. These are usually the simple plants that grow near to the water bodies. It contains a kind of chlorophyll pigments that act as a primary coloring agent.
Avi
they are eukaryotic and most lived in fresh water. they are photosynthetic that's, they contain chlorophyll and store starch in discrete chloroplast.
Prince
are bacteria important to man
just Reply
yes, depending on the type of bacteria .eg the normal florals, the latic acid batteries etc are important to man
Lois
I mean latic acid bacterial
Lois
I don't understand this topic
Jane Reply
what topic is that
Rose
sahi kon hai bhosri ke
saurabh Reply
define metabolism of carbohydrates with example
Thavasi Reply
what is sterilization a
Sani
the process of keep equipment free from bacteria
shar
is it only bacteria?
Lois
no undesirable fungi and contamination also.
Khushbu
what is streak plate method
Offikwu
what is the biofilm
Dimingu
metabolism is the sum of all the biochemical reaction required for energy generation and use of that energy to synthesize cell materials from small molecules in environment.
Alex
boclenia
Pooja
what are granulocytes
Shawnitta Reply
e.coli
Sukhdeep
granulocytes are type of WBCs which contains granules in the cytoplasm
Owili
what is mutation
Cynthia
it is the interchange of genes from their normal sequence
Esther
is an heritable change of the base-pair sequence of genetic material
Elizabeth
suitable example for prokaryotes
Suvetha Reply
one of the possible early sources of energy was
Suvetha
uv radiation and lighting
Anisha
e coli is the example of prokaryotes
Sukhdeep
archaea too
Noel
which is the specific virus causing typhoid
Jeremiah Reply
it's caused by a virulent bacteria called Salmonella Typhi
Sarah
write the life cycle of HIV
Firomsa Reply
describe the internal and external structure of prokaryotic cell in terms of there appearance and functions
Lenia Reply
compare and contrast similar structures found in prokaryotic and eukaryotic cells
Lenia
control of microorganisms
ISTEFAZUL Reply
what is sterilization
Sani
how can a doctor treat a person affected by endospore forming bacteria in his/her wound?
Mambo Reply
define disinfectant
Sani
the process of killing
shar
the process of killing microorganisms
shar

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Source:  OpenStax, Microbiology. OpenStax CNX. Nov 01, 2016 Download for free at http://cnx.org/content/col12087/1.4
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