Epidemiology of Infectious

Diseases

-Ma. Eufemia M. Collao, MD

DPAFP
Objectives:
At the end of the session, the student must be
able to:
1. Define the following:
• sporadic, endemic, epidemic, pandemic,
• herd immunity,
• attack rates
2. Differentiate:
Communicable from non-communicable
disease
Isolation from quarantine
Mechanical from biological vector
Incubation from generation period
Cont’n…

1. Describe the intrinsic properties of

disease agents
2. Discuss the different host agent
interaction.
3. Discuss the different pathogenetic
mechanism
4. Discuss the different mechanism of
transmission.
Infectious Diseases
Also known as communicable
diseases.
Transmitted directly to man from man
(anthropo-zoonoses) or from animals
(zoonoses) to man.
Characterized by cyclic periodicities
and seasonal predilections
Genetics only an indirect role =
predispositions
The EPIDEMIOLOGIC TRIANGLE
MAN

ENVIRONMENT DISEASE
AGENT
Disease Transmission is Affected
By :

Factors intrinsic to man

Factors intrinsic to the
disease
Role of vectors
Factors intrinsic to the
environment
The study of these factors and
their dynamics in disease
transmission is

EPIDEMIOLOGY
The methodology for this study
consists of

Data generation
Data analysis
Evidence-based
intervention planning
The main tool used for data
generation is

DISEASE
SURVEILLANCE
SOURCES OF DATA

FIELD HEALTH SERVICE

INFORMATION SYSTEM
PROGRAM-BASED
REPORTS
NESS REPORTS
Terms:
Endemic:
Sporadic: occurrence of
disease, on and off, cases
seemingly unrelated to each
other, low incidence level
Pandemic: a marked increase
in disease incidence of world-
wide or continental distribution,
usually of sudden occurrence
Herd immunity: resistance of
a group to invasion and
spread of an infectious
agent
Secondary attack rate: rate
thru which spread of
disease is measured
Secondary attack rate: number of
cases of a disease developing during
a stated time period among those
members of a closed group who are
at risk
= # of new cases in a group – initial
_________case(s)___________
# of susceptible persons in the grp –
initial cases
EPIDEMICS

Also called outbreaks

Occurrence of a disease over and
above its expected levels of
occurrence.
Should be qualified by the presence
of clustering : chronological and
geographic
ESTABLISHNG LEVELS OF
OCCURRENCE

Taking the averages (over

a period of 3-4 years)
Consider highs and lows
Use of incidence and
prevalence
EPIDEMICS

Are calamities in themselves

May result from the occurrence of
natural or physical calamities
Occurs as a result of environmental
sanitation breakdown, displacement
of populations and more conducive
environmental conditions for disease
prevalence and transmission
NECESSARY…

EARLY DETECTION AND

MANAGEMENT OF CASES
SURVEILLANCE : monitor trends
IDENTIFY CAUSE
PLAN PREVENTIVE MEASURES
Origin/ Cause of Epidemics:

New Disease
Introduction of disease to the
community for the first time
Dse of lower animals affecting
man for the first time
Dse discovered for the first time
Old Disease
Introduction of new strain of the disease
Immigration of a large number of
susceptible individuals
Decrease resistance of population due
to catastrophe such as famine,
earthquakes, floods, etc
Increased virulence/ pathogenicity
Increased agent population
Termination of Epidemic

Exhaustion of susceptibles
Elimination of the agent
Closure of secondary transmission
Differentiate:

• Communicable vs non-
communicable disease
• Isolation vs quarantine
• Mechanical vs biological
reservoir
• Incubation period vs generation
period
Communicable disease: due to a
specific infectious agent or its toxic
products, arising through
transmission of that agent or its
products from reservoir to susceptible
host, either directly as from an
infected person or animal or indirectly
by the agency of an intermediate
plant or animal host, a vector, or the
inanimate environment; also includes
infestation
Incubation period: from the time the
agent enters the host to the time
the disease becomes manifest.
Generation period: period between
the receipt of infection by a host
and maximal communicability of the
host
Isolation vs quarantine
Mechanical vs biological vector
Describe the intrinsic properties of
disease agents
Discuss the different host-agent
interaction.
Discuss the different pathogenetic
mechanism
Discuss the different mechanism of
transmission.
The Ecologic Model of
Disease Causation
1. The lever or Balance

Host
agent

Environment
The Ecologic Model of
Disease Causation
1. The lever or Balance

Host

agent

Environment
Ecologic Model

Host

agent environment
Agent: any element, substance, or
force whether living or non-living, the
presence of which can initiate or
perpetuate a disease process
Types:
Living vs non-living
Physical , mechanical
Chemical, nutrients
Characteristics:
Inherent: physical features, biologic
requirements, chemical make-up,
viability, resistance
Those directly related to man: infectivity,
pathogenicity, virulence, antigenicity
Those related to the environment:
reservoirs and sources of infection and
mode of transmission
Those directly related to man

Infectivity: ability to gain access and

adapt to the human host to the extent
of finding lodgment and multiplication
Pathogenicity: measures the ability of
the agent to cause a specific reaction
Virulence: severity of the reaction,
usually measured in terms of fatality
Antigenicity: ability to stimulate a
response
Different pathogenetic
mechanisms
Direct tissue invasion
Production of a toxin
Immunologic enhancement or allergic
reaction leading to damage to the
host
Persistent or latent infection
Enhancement of host susceptibility to
drugs of otherwise minimal toxicity
Immune suppression
Different mechanisms of
transmission
Direct transmission
Indirect transmission:
Vehicle-borne
Vector-borne:
3. Mechanical
4. biological
Airborne: 1-5 um
6. Droplet nuclei
7. Dust
 Disease Causation
1. Agent increase in virulence or
taken in massive doses
2. Agent remains the same but there
is a change in the characteristic of the
host- a) Decrease in host resistance
b) Change in the activity of the
host – increase in contact with the
diseased person
Isolation & Quarantine

Isolation – separation during the

period of communicability of infected
persons or animals from others .
To prevent the spread of the disease
to those who are susceptible.
Isolation & Quarantine

Categories of Isolation : 7 categories

A) Hands must be washed after
contact with the patient or potentially
contaminated articles and before
taking care of another patient.
B) Articles contaminated with
infectious materials should be
appropriately discarded or bagged &
labeled before being sent for
decontamination & reprocessing.
Isolation & Quarantine
Categories of Isolation : 7 categories
1. Strict Isolation – to prevent highly
contagious and virulent infections that may
spread by both air and contact .
Specification:
Private room
Use of mask , gloves & gown for all
persons entering the room.
Special ventilation requirements with the
room at negative pressure to surrounding
areas is desirable
Isolation & Quarantine

Categories of Isolation : 7 categories

2. Contact Isolation –
For less highly transmissible or
serious infections
Disease or conditions which are
spread primarily by close or direct
contact.
Isolation & Quarantine

Categories of Isolation : 7 categories

3. Respiratory Isolation – diseases
spread through the air
4. Tuberculosis Isolation-
5. Enteric Precaution
6. Drainage Secretion precaution
7.Blood & Body fluid precaution