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EO 004.01

EO 004.01. Conduct Epidemiological Investigations. Basic Epidemiology. References: Required reporting of communicable disease information & data to DFHP http://hr.ottawa-hull.mil.ca/health-sante/pd/pol/word/DFHP-CDCP-2004-03-eng.doc

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EO 004.01

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  1. EO 004.01 Conduct Epidemiological Investigations

  2. Basic Epidemiology References: • Required reporting of communicable disease information & data to DFHP http://hr.ottawa-hull.mil.ca/health-sante/pd/pol/word/DFHP-CDCP-2004-03-eng.doc • Repellent use in the CF to prevent insect bites and associated diseases http://hr.ottawa-hull.mil.ca/health-sante/pd/pol/word/DFHP-CDCP-2008-02s-eng.doc • CFP 213 CF Health Manual A-MD-213-001/FP-001 • Guidelines for Diving Medical Officers, Medications and Divers (2006) http://hr.ottawa-hull.mil.ca/health-sante/pd/pol/pdf/divers-plongee-medic-eng.pdf • Policy and Directives, 4410-19, Preventive Medicine Program and Personnel http://hr.ottawa-hull.mil.ca/health-sante/pd/pol/word/4410-19-eng.doc • CCDR – Canadian Recommendations for the Prevention and Treatment of Malaria Among International Travellers – 2009, Supplement June 2009, Volume 35s1 http://wwwphac-aspc.gc.ca/publicat/ccdr-rmtc/09vol35/35s1/index-eng.php • Canadian TB Standards, 6th Edition 2007 • World Health Organization ICD-10 www.who.int/classifications/icd/en/

  3. Basic Epidemiology References Con’t: • World Health Organization, ICD-10 www.who.int/classifications/icd/en/ • World Health Organization, International Travel Health: Country List http://www.who.int/countries/en/ • Center for Disease Control (CDC), Traveller’s Health http://wwwnc.cdc.gov/travel/ • Control of Communicable Diseases Manual, 18th Edition. • Primer of Epidemiology, 5th Edition, Ed Gary D Friedman

  4. Basic Epidemiology Communicable Diseases: • Kill over 14 million people each year; • 46% of deaths in developing countries are due to communicable diseases; and • Of these, 90% are attributed to: • Diarrheal diseases in children; • AIDS; • Tuberculosis; • Malaria; and • Measles.

  5. Basic Epidemiology • Definitions: • Identification; • Occurrence; • Reservoir; • Mode of transmission; • Incubation period; • Period of communicability; • Susceptibility; • Methods of control; • Carrier; • Endemic; • Epidemic; • Quarantine; • Transmission of infectious agents; and • Zoonosis.

  6. Identification • presents the main clinical features of the disease and differentiates it from others that may have a similar clinical picture. Noted are the laboratory tests most commonly used to identify or confirm the etiological agents.

  7. Occurrence • Provides information on where the disease is known to occur and in which population groups it is most likely to occur. Information on past or current outbreaks may be included.

  8. Mode of transmission • Transmission describes the mechanisms by which the infectious agent spreads to humans.

  9. Incubation Period • The time interval between initial contact with the infectious organisms and the first appearance of symptoms associated with the infection.

  10. Period of communicability • The time during which an infectious agent may be transferred directly or indirectly from: • an infected person to another person; • An infected animal to a person; or • From an infected person to animals (including arthropods)

  11. Susceptibility • (including immunity) provides information on human or animal populations at risk of infection or that are resistant to either infection or disease. Information on subsequent immunity consecutive to infection is also given.

  12. Methods of control • Preventive measures for individuals or groups; • Control of Patients, contacts & immediate environment: • Measures designed to prevent further spread of the disease from infected persons and the best treatment to minimize the period of communicability & reduce morbidity & mortality

  13. Carrier • A person or an animal that shows no symptoms of a disease but harbors the infectious agent of that disease and is capable of transmitting it to others.

  14. Endemic • A term denoting the habitual presence of a disease or infectious agent within a given geographic area or population group; may also refer to the usual prevalence of a given disease within such an area; • Hyper endemic expresses a habitual presence at all ages at a high level of incidence; and • Holoendemic (referred mainly to malaria) a high level of prevalence with high spleen rates in children & lower rates in adults.

  15. Epidemic • In a defined community or region, the occurrence of cases of an illness (outbreak) with a frequency clearly in excess of normal expectancy.

  16. Quarantine • Restriction of activities for well persons or animals who have been exposed or considered high risk of exposure to a case of communicable disease during it’s period of communicability (i.e. contacts) to prevent the further spread of the disease. The two main types of quarantine include:

  17. Quarantine • Absolute quarantine: limit freedom of movement to those exposed for a period not longer than the longest usual incubation period; and • Modified quarantine: Selective, partial limitation of freedom of movement of contacts based on presumed susceptibility i.e. exclusion of children from school for observation.

  18. Transmission of infectious agents • Any mechanism by which an infectious agent is spread from a source or reservoir to a person. • These include: • Direct Transmission • Indirect transmission

  19. Transmission of infectious agents • Direct Transmission: • Direct & essentially immediate transfer of infectious agents to a receptive portal of entry through which animal or human infection may take place i.e. touching, kissing, biting etc.

  20. Transmission of infectious agents • Indirect transmission: • (vehicle-borne): Contaminated objects (toys, tissues etc); • Vector-borne: • Mechanical: ie. Insect carrying organism on its feet or passage through it’s gastrointestinal tract. This does not require multiplication or development of the organism;

  21. Transmission of infectious agents Vector-borne: • Biological: Propagation or multiplication is required before the arthropod can transmit the infective form (an incubation period); transstadial transmission indicates it’s passage from one stage of life cycle to another, as from nymph to adult

  22. Transmission of infectious agents • Airborne transmission: dissemination of microbial aerosols to a portal entry, usually respiratory tract i.e. microbial aerosol particles suspended in the air. They may stay suspended for long periods. Particles 1to 5 micrometer may remain suspended

  23. Zoonosis • An infection or infectious agent transmissible under natural conditions from vertebrate animals to humans. May be enzootic or epizootic.

  24. Questions

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