Toxic Injuries

(endogenous and exogenous)

Physical Injuries

Deficit produced injuries

Infective injuries

Public health improvements

Ageing population

Improvements in medical care

Ischemic means lack of blood flow to a body part.

It is the highest cause of death for both low, middle, AND high income countries.

Biological

Chemical

Environmental

Nutritional

Colonization

Infestation

Contamination

Presence of infectious agent in host

Presence of an external agent on the host (lice)

Presence of infectious agent on an article

Types of carriers

Incubatory - capable of infecting others before displaying symptoms (HIV, measles)

Convalescent- recovering, but still capable of infecting others (salmonella)

Chronic- continue to infect others for 1 year or longer after infection themselves (infants with hep b)

Inapparent- never develop an illness but are capable of spreading disease (polio, hep a)

1. Latent Period

2. Incubation Period

1.Time delay between exposure and contagiousness

2. Time delay between exposure and symptoms

Primary case

Secondary case

Someone who acquires a disease from the exposure

Someone who acquires the disease from a pimary case

Preclinical phase

Clinical phase

1. Time between exposure to agent and diagnosis my medical testing.

2. Time between when symptoms occur and the patient either dies or gets better, with or without immunity.

Death

Severe symptoms

Moderate symptoms

Inapparent

Etiologic agent

Reservoir of infection

portal of exit

mode of transmission

portal of entry

susceptible host

Human

Animal

Environmental

Respiratory

Urinary-genital

Alimentary

Skin

Transplacental

Direct - verticle (mother to fetus) and horizontal

Indirect- Vehicle born (water, fomites, soil)

Air born

Vector born - mosquitoes

Apparent/Unapparent infection ratio

# with symptoms/# infected

Case fatality ratio

# deaths/# of cases of disease

Natural

Active - getting an infection and developing immunity

Passive - receiving immunity from mother

Artificial

active - vaccination

Passive - recieving antitoxins or IG

1. disease must be restricted to a single host

2. transmission must be direct between host and host

3. Infections must introduce solid immunity

4. Populations are constantly mixing

Primary - prevents onset of infection from occuring eg vaccines

Seconday - treatment of those who have risk factor but are not yet exhibiting illness eg pap smear and bp screenings

Tertiary - preventing complications of an illness, glasses, diabetes management.

BCG (tb vaccine)

Polio (oral)

Diptheria

Tetanus

Pertussis

Rubella

Measles

Yellow Fever

Hib

HPV

Varicella

Meningitis

Flu

Mumps

S pneumonaie (why is this not part of EPI if pneumonia is such a big case of death)

Viral illness

Vector born

Africa and South America

Erradication failed d/t massive number of mosquitos and sylvatic cycle

flu like symptoms but can cause liver damage

Bacterial infection

Skin to sking transmission

Africa, south america, asia

bone joint and soft tissue destruction

erradication failed d/t lack of support for rural areas

eliminated from india

Erradicated in 1979

Viral

Causes gross rashes

vaccination, surveillence, containment strategy

Sensitivity - the accuracy at identifying those who have the diseases

(tp/tp+fn)

Specificty - the ability of the test to identify those who do NOT have the disease

tn/tn+fp

Positive predective value: what percentage of people who test postive actually have the disease in question tp/tp+fp

Negative predictive value: what percentage of people who test negative actually do NOT have the disease

tn/tn+fn

TB

Dracunculiasis

Onchocerciasis

Measles

Syphillis

Leprosy