Epidemiological Terms and Definitions • Disease and health related conditions”

Epidemiology indicates that everything around us and

• Epidemiology- the study of the frequency, everything we do affects our health.
distribution and determinants of disease and
• "Frequency" shows that “epidemiology” is a
Epidemiological Terms other health related conditions in human
populations, and the application of this study to quantitative science (e.g. occurrence of illness is
and Definitions the promotion of health and to the prevention and measured using morbidity rates).
control of health problems. • Distribution" refers to the occurrence of disease
• Some of the components in the definition of by place, person and time.
epidemiology are: • Determinants” These are factors that determine
• Populations” Epidemiology focuses on the whether or not a person will get a disease.
effects of disease on populations

• The causes of diseases are classified Definition of other epidemiological terms:

epidemiologically as:
Definition of other epidemiological terms:
• 1. Epidemics - the occurrence of any health related
• Primary causes - Factors that are necessary for a condition in a given population in excess of the usual • 6. Infection - the entry and development or
multiplication of an infectious agent in the body of man
disease to occur, and in whose absence the disease will frequency in that population. or animal
not occur (e.g. infectious agents, vitamin deficiencies). • 2. Endemic - a disease that is usually present in a • 7. Contamination – presence of living infectious agent
• 1. Contributing, predisposing, or aggravating population or in an area at a more or less stable level. upon articles
factors - Risk factors whose presence is associated • 3. Sporadic - a disease that does not occur in that • 8. Infestation – presence of living infectious agent on
with an increased probability that disease will population, except at occasional and irregular intervals. the exterior surface of the body
occur/develop later(e.g. Poverty is the most powerful • 4. Pandemic - an epidemic disease which occurs • 9. Infectious - caused by microbes and can be
worldwide transmitted to other persons.
environmental determinant in the disease occurrence,
Habit of cigarette smoking leads to lung cancer. Having • 5. Disease - a state of physiological or psychological • 10. Infectious agent- an agent capable of causing
infection
multiple sexual partners results in STI). dysfunction.

• Incidence refers to the occurrence of new cases of Disease transmission cycle Chain of Disease Transmission
disease or injury in a population over a specified period Communicable diseases • This refers to a logical sequence of factors or links of a
of time. Although some epidemiologists use incidence to chain that are essential to the development of the
mean the number of new cases in a community, others • These are illnesses due to specific infectious infectious agent and propagation of disease.
use incidence to mean the number of new cases per agents or its toxic products, which arise through • The six factors involved in the chain of disease
unit of population. transmission of that agent, or its toxic products transmission are:
• Prevalence, sometimes referred to as prevalence rate, from an infected person, animal or inanimate a. Infectious agent (etiology or causative agent)
is the proportion of persons in a population who have a reservoir to a susceptible host, either directly or b. Reservoir
particular disease or attribute at a specified point in time indirectly, through an intermediate plant or animal
or over a specified period of time. Prevalence differs c. Portal of exit
host, vector or inanimate environment. d. Mode of transmission
from incidence in that prevalence includes all cases,
both new and preexisting, in the population at the e. Portal of entry
specified time, whereas incidence is limited to new f. Susceptible host
cases only.

Disease transmission cycle a) Infectious Agent

Disease transmission cycle • Infectious agent: An organism that is capable of
producing infection or infectious disease.
• On the basis of their size, etiological agents are
generally classified into:
• Metazoa (multicellular organisms). (e.g. Helminths).
• Protozoa (Unicellular organisms) (e.g. Ameobae)
• Bacteria (e.g. Treponema pallidum, Mycobacterium
tuberculosis, etc.)
• Fungus (e.g. Candida albicans)
• Virus (e.g. Chickenpox, polio, etc.)

b) Reservoir of infection Reservoir of infection Reservoir of infection

• Reservoir of infection: Any person, animal, arthropod, • 2. Animals: Some infective agents that affect man have • 3. Non-living things as reservoir: Many of the
plant, soil or substance (or combination of these) in their reservoir in animals. The term “zoonosis” is applied agents are basically saprophytes living in soil and
which an infectious agent normally lives and multiplies, to disease transmission from animals to man under fully adapted to live freely in nature. Biologically,
on which it depends primarily for survival and where it natural conditions. For example: they are usually equipped to withstand marked
reproduces itself in such a manner that it can be • Bovine tuberculosis - cow to man environmental changes in temperature and
transmitted to a susceptible host. humidity.
• Brucellosis - Cows, pigs and goats to man
• Types of reservoirs • E.g. Clostridium botulinum etiologic agent of
• Anthrax - Cattle, sheep, goats, horses to man
• 1. Man: There are a number of important pathogens Botulism
that are specifically adapted to man, such as: measles, • Rabies - Dogs, foxes and other wild animals to man
smallpox, typhoid, meningococcal meningitis, gonorrhea • Man is not an essential part (usual reservoir) of the life Clostridium tetani etiologic agent of Tetanus
and syphilis. The cycle of transmission is from human to cycle of the agent. Clostridium welchi etiologic agent of gas
human. gangrene
Animal …….. Animal…………Animal
↓
Human
c) Portal of exit d) Mode of transmission • b.Direct horizontal
• Mode of transmission (mechanism of transmission Direct touching, biting, kissing, sexual
• Portal of exit (mode of escape from the of infection): Refers to the mechanisms by which an
reservoir): This is the site through which the intercourse, droplet spread onto the conjunctiva
infectious agent is transferred from one person to
agent escapes from the reservoir. another or from a reservoir to a new host. Transmission or onto mucus membrane of eye, nose or mouth
may be direct or indirect. during sneezing coughing, spitting or talking;
• Examples include: Usually limited to a distance of about one meter
• GIT: typhoid fever, bacillary dysentery, amoebic • 1. Direct transmission: Consists of essentially
immediate transfer of infectious agents from an infected or less.
dysentery, cholera, ascariasis, etc.
host or reservoir to an appropriate portal of entry. This • Indirect transmission
• Respiratory: tuberculosis, common cold, etc. could be:
• Skin and mucus membranes: Syphilis • a. Vehicle-borne transmission: Indirect contact
• a. Direct Vertical
through contaminated inanimate objects (fomites)
Such as: transplacental transmission of syphilis,
like:
HIV, etc.
• Bedding, toys, handkerchiefs, soiled clothes,
cooking or eating utensils, surgical instruments.

Mode of transmission Mode of transmission Mode of transmission

• b. Vector-borne transmission: Occurs when the • C. Air-borne transmission: Dissemination of microbial
• 2. Contaminated food and water agent by air to a suitable portal of entry, usually the
• Biological products like blood, serum, plasma or infectious agent is conveyed by an arthropod respiratory tract.
IV-fluids or any substance serving as intermediate (insect) to a susceptible host.
• Two types of particles are implicated in this kind of
means by which an infectious agent is • 1. Mechanical transmission: The arthropod spread: dusts and droplet nuclei.
transported and introduced into a susceptible transports the agent by soiling its feet or • Dust: small infectious particles of widely varying size
host through a suitable portal of entry. The agent proboscis, in which case multiplication of the that may arise from soil, clothes, bedding or
may or may not multiply or develop in the vehicle agent in the vector does not occur. (e.g. contaminated floors and be resuspended by air
before it is introduced into man. common house fly.) currents.
• 2. Biological transmission: This is when the • Droplet nuclei : Small residues resulting from
agent multiplies in the arthropod before it is evaporation of fluid (droplets emitted by an infected
transmitted, such as the transmission of host). They usuallyremain suspended in the air for
long periods of time.
malaria by mosquito.

f) Susceptible host Susceptible host

e) Portal of entry
• Susceptible host (host factors): A person or animal • Specific factors
• Portal of entry: The site in which the infectious lacking sufficient resistance to a particular pathogenic • Genetic-hemoglobin resistant to Plasmodium
agent enters to the susceptible host. For agent to prevent disease if or when exposed.
falciparum
example: Occurrence of infection and its outcome are in part
determined by host factors. The term “immunity” is used • Naturally acquired or artificially induced immunity.
• Mucus membrane Acquired immunity may be active or passive.
to describe the ability of the host to resist infection.
• Skin
• Resistance to infection is determined by non-specific • Active immunity- acquired following actual infection
• Respiratory tract and specific factors: or immunization.
• GIT • Non-specific factors • Passive immunity- pre-formed antibodies given to the
• Blood • Skin and mucus membrane host.
• Mucus, tears, gastric secretion
• Reflex responses such as coughing and sneezing.

Carrier and its Type Time Course of infectious Diseases

• A carrier is an infected person or animal who does not
•c. Convalescent Carriers: These are
have apparent clinical disease but is a potential source those who continue to harbor the infective • Incubation period: It is the interval of time
of infection to others. between infection of the host and the first
agent after recovering from the illness. appearance of symptoms and signs of the
• a. Healthy or asymptomatic carriers: These are
persons whose infection remains unapparent. For E.g. Diphtheria, Hepatitis B virus. disease.
example, in poliovirus, meningococcus and hepatitis •d. Chronic Carriers: The carrier state
virus infections, there is a high carrier rate.
• b. Incubatory or precocious carriers: These are
persists for a long period of time. E.g.
individuals or persons who excrete the pathogen Typhoid fever, Hepatitis B virus infection
during the incubation period (i.e. before the onset of
symptoms or before the characteristic features of the
disease are manifested). E.g. Measles, mumps,
chickenpox and hepatitis.

• Prodromal period: It is the interval between the

onset of symptoms of an infectious disease and
the appearance of characteristic manifestations.
For example, in a measles patient, fever and
coryza occur in the first three days and Koplick
spots in the buccal mucosa and characteristics
skin lesions appear on the fourth day.
• Period of communicability: The period during
which that particular communicable disease
(infectious agent) is transmitted from the infected
person to the susceptible host.