LECOM Public Health Dr. Carty Slides

Question Answer
proportion of people with disease correctly classified at positive (true positives) TP / (TP + FN)
sensitivity TP / (TP + FN)
proportion of well people correctly classified as negative (true negatives) TN / (FP + TN)
specificity TN / (FP + TN)
How can one acquire Salmonella, E. Coli O157, Campylobacter infection, Brucellosis, Q fever, Haverhill fever, Tick-borne encephalitis (when animal infected)? consuming untreated milk, cream, yogurt, adn curd cheese
How can one acquire Q fever, tularemia, plague, anthrax? unpasteurized bone meal
How can one acquire plague, tularemia, rabies? skinning and butchering wild animals
How can one acquire Q fever, Streptococcal skin infection, Brucellosis, Skin infection (Erysipelothrix), Streptococcus suis systemic infections, Anthrax, Crimean-congo hemorrhagic fever (from ostriches)? butchering farm animals
How can one acquire Toxoplasmosis, Trichinellosis (from pork), Pork or beef tapeworms, Salmonella, E.Coli O157, Campylobacter infection? eating undercooked meat
How can one acquire leptospirosis? ingestion or inoculation of animal urine
How could one acquire Tick-borne encephalitis, Borreliosis, Arboviral infection, Hantavirus infections? forestry working in warm climates
How would one acquire Brucella melitensis? unpasteurized goat cheese
How would one acquire Brucella suis? slaughtering pigs
How would one acquire Brucella abortus? raising beef
proportion of people who test positive who actually have the disease positive predictive value
positive predictive value [TP / (TP + FP)]
proportion of people who test negative who are actually free of disease negative predictive value
negative predictive value [TN / (FN + TN)]
What do Anthrax (Bacillus anthracis, Botulism (Clostridium botulinum toxin), Plague (Yersinia pestis), Smallpox (variola major), Tularemia (Francisella tularensis), and Viral hemorrhagic fevers have in common Category A agents
Influenza, Community-acquired pneumonias, Urinary tract infection, Meningococcal disease, Sexually transmitted disease diseases common worldwide
Sunburn, Heat exhaustion and heatstroke, Dermatophyte infections, Folliculitis, Cold injury, Altitude sickness Diseases related to climate and environment
Hepatitis A, Hepatitis E, Viral gastroenteritis, Traveler's diarrhea, Bacterial food poisoning, Bacillary dysentery, Amoebiasis, Cryptosporidiosis, Helminth infection, HIV infection, STD, Diphtheria diseases controllable by public health measures
Leptospirosis, Hookworms, Strongyloidiasis, Guinea worms, Liver flukes diseases associated with contact with mud and water
Yellow fever, Dengue hemorrhagic fever, Lassa fever, Marburg fever, Ebola fever, Crimean-congo hemorrhagic fever Viral Hemorrhagic fever
Dengue fever, Arboviral encephalitis, Rickettsial infection, Plague, Lyme disease, Malaria, Leishmaniasis, Trypanosomiasis, Filariasis, Onchocerciasis Diseases with arthropod vector
criteria for fever of unknown origin illness that has lasted 3 weeks, Fever of more than 38.3°C on several occasions, No diagnosis after routine work up for 3 days in hospital or after 3+ outpatient visits
HAI Healthcare Associated infection
Dr. Semmelweis advocated washing hands before birthing a child
Women used to die of “ChildBed Fever” aka… Strep Pyogenes
Lister used this to sterilize equipment carbolic acid
CDC estimates HAI’s cost this much per year 30 billion
Most common HAI UTI
3 most common SERIOUS HAi illnesses Surgical site infx, pneumonia, Bacteremia
Most common Gram + HAI bugs Staph aureus, Coag negative Staph, Enterococci sp.
Most common Gram – HAI bugs E. coli, Pseudomonas, Enterobacter sp., Klebsiella
C. Diff Stain and 2 virulence factors Gram + anaerobe, Spore former, Toxin producer
C. Dif risk factors >65 yo, hospitalized and on ABX
C.Dif annual cost to healthcare 3.2 billion
HAI Factor 1 Antimicrobial use in Hospitals and Longterm Care facilities
Factor 1 results VRE, MRSA, Multi-Drug resistant C. Diff
Fact 2 Infection Control
How to improve Factor 2 Better surveillance and reporting, better invasive devices, hand washing programs
Most Common mode of pathogen transmission via hands
Factor 3: Patients are susceptible because they are immune-compromised/suppressed
NHSN stands for National Healthcare Safety Network
NHSN date organized in these 4 categories Patient Safety, Healthcare personnel safety, Biovigilance, R&D
The Cause Etiology
Number of cases resulting in illness/poor health Morbidity
Number of cases resulting in Dealth Mortality
Occurrence of disease greater than would be expected in a particular place &time (community) outbreak
sudden and widespread outbreak of disease within population, group or specific area epidemic
ongoing process of disease within population. group, or specific area endemic
occurs over large geographic areas, possibly worldwide pandemic
number of new cases of disease or injury in population during a specific time period incidence
TOTAL number of cases of disease or injury in a population at a particular point in time or during a specific time period prevalence
Who collects data to determine outbreaks vs epidemics vs pandemics local and state health departments then CDC
Worldwide Agency that monitors EIDs WHO
2 most important population properties for disease spread Density and susceptibility
Theorys how/why EIDs still exist World travel, humans encroaching on undeveloped areas, immigration, poor human hygiene, over/mis-use of ABX, population growth
SARS: when it started & when reported Nov. 2002 & Feb. 2003
Biggest reason for dissemination High Speed international travel
1 person in a Hong Kong hotel infected how many people 16
SARS: causative agent and description SARSCoV, coronavirus, + ssRNA, Large & Enveloped
SARS transmission respiratory aerosol, infects nasal epithelial cells
What stopped SARs? Quarantine , cooperation, collaboration, travel restrictions
Leading cause of death heart disease then cancer
Neo, post neo-, infant high mortality Other, then congenital then low birth weight
Mortality from 1-14yo unintentional injuries, other, cancer
Most decreased cause of 1-14yo mortality from 97-07 Unintentional injuries
Mortality 15-24yo Unintentional injury, homicide, suicide
Mortality 25-44yo Other, unintentional, cancer’
Most decreased cause of 25-44yo mortality Cancer and HIV
Mortality 45-64yo Cancer, other, Heart Disease
Most decreased cause of 45-64yo mortality Cancer and Heart disease
Mortality 65+ yo Heart Disease, Other, Caner
Most decreased cause of 65+yo mortality Heart disease
Age group in which cigarette smoking has declined grade -12
Childhood obesity rate 1 in 5
Adult obesity rate 1 in 3
Adult Obesity and overweight 2 in 3
Rates of serum cholesterol from 88-94 and 05-08 Declined
Statin use in 45+yo has nearly increased 10 fold
An increase in delay in seeking healthcare due to increased cost for these 2 type of Pts uninsured & private insurance
From 99-09 % of working age adults with private insurance decreased
From 99-09 % of working age adults who were uninsured increased

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