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Background & Surveillance (1) Understand the Clinical Approach (health of individuals) vs Public Health Approach (health of populations) (2) Understand the history and development of epidemiology (3) Understand the roles of epidemiology in public health and the steps in solving health problems (4) Understand the Natural History and Spectrum of Disease. Understand in broad terms the impact of infectious (bacterial, viral, fungal, protest and prion diseases) and noninfectious causes of disease (such as accidents, exposures, and toxicities) (5) Understand the basic epidemiological and public health terms found in the glossary of CDCs Principles of Epidemiology in Public Health Practice (e.g., outbreak, epidemic, pandemic, surveillance, risk, vector, etc.) (6) Understand the role of Surveillance in identifying health problems, the 5-Step Process for Surveillance. the types of surveillance and the attributes of a surveillance system Outbreak Investigation (1) Analyze actual or hypothetical outbreaks given in case scenarios (2) Understand Experimental and Observational studies and the Types of Epidemiological Studies (e.g., case control, cohort, ecological, cross-sectional. Know the advantages and disadvantages of each. Recognize various fundamental study designs and identify which is appropriate to use in analysis of presented outbreak scenarios (3) Identify the Steps in an Outbreak Investigation and how they guide hypothesis generation (4) Identify the problem using person, place, and time triad to formulate case definitions
Clinical vs. Public Health Approaches Clinical Approach: Focus on individual patients; diagnosing and treating illnesses. Public Health Approach: Focus on populations, disease prevention and health promotion. History and Development of Epidemiology Ancient Era o Hippocrates : Linked disease to environment/lifestyle (400 BCE). o Romans : Developed sanitation systems; clean water recognition. Middle Ages o Quarantine : Early isolation practices for plague control. o Miasma Theory : Belief in "bad air" as cause of disease. Renaissance/Early Modern o John Graunt (1662): Statistical analysis of mortality data. o Leeuwenhoek : Observes microbes (1670s). 19th Century o Edward Jenner (1796): Smallpox vaccine. o John Snow (1854): Linked cholera to water sources. Germ Theory (Late 1800s) o Pasteur & Koch : Established microbes as disease agents; Koch’s postulates. 20th Century o Epidemiological Methods : Cohort studies (e.g., Framingham Heart Study). o Global Health & Technology : Digital tools, genetics, disease prevention. Roles of Epidemiology in Public Health Basis for understanding disease patterns in populations. Identifies risk factors, causes, and disease distribution. Guides public health interventions and policy. Natural History and Spectrum of Disease Natural History: Progression from disease onset to resolution. o Stages : Susceptibility ➔ Subclinical ➔ Clinical ➔ Recovery/Disability/Death. Spectrum: Disease severity varies based on individual factors (e.g., immunity). Impact of Infectious vs. Noninfectious Diseases Infectious Diseases o Pathogens: Bacteria, viruses, fungi, protozoa, prions. o Impact: Epidemics, pandemics, high morbidity/mortality. Noninfectious Causes o Accidents : Injuries, physical trauma. o Exposures : Harmful substances (e.g., asbestos).