The Epidemiology of Communicable Diseases
of Public Health Importance
EPID 621 John Marr, MD, MPH, FACP
Infectious Disease Epidemiology Summer 2006
Semester course; 3 lecture hours. 3 credits. Prerequisite: EPID 571. This
course will discuss the origins of epidemiology and how epidemiology
methods are continually applied to the study of communicable diseases.
Several infectious diseases will be studied in depth to show the progression
toward characterization of the natural history of the diseases and how
policies regarding prevention have been defined. Smallpox, HIV/AIDS,
the hepatitis family of agents and a vector-borne disease will be studied.
In addition, the topic of antibiotic resistance will be covered in depth.
How the epidemiology of an infectious agent relates to bioterrorism also
will be discussed. Summer semester
OBJECTIVES (first session):
- Outline infectious disease classification systems by Agent and Mode of Transmission
- Review arthropod-borne viral pathogens and associated diseases & clinical characteristics
- Review the public health implications and epidemiologic relevance of these diseases
Objectives for each of the following sessions:
- Review pathogens, associated diseases & clinical characteristics
- Review the public health implications and epidemiologic relevance of the diseases
- Demonstrate important concepts related to the applied epidemiology of infectious / toxic agents using a case study
- Participate in library research assignments using Internet resources
COURSE OUTLINE
May 24
Introduction to communicable diseases of public health importance.
Course outline, expectations, required texts, library assignments, exams
Infectious disease terminologies, classifications, nomenclatures
Classification of infections by agents and modes of transmission
Introduction to arthropod borne diseases - Arboviruses:
Fever/rash syndromes (dengue, sand fly fever, etc.)
Hemorrhagic syndromes (yellow fever, Crimean-Congo HF, etc. )
Encephalitis (EEE, WEE, SLE, JE, etc.)
West Nile disease and Alexander the Great
LIBRARY ASSIGNMENT
May 31
Other arthropod-borne diseases: bacterial, protozoan and helminthic
Bacterial:
Traditional rickettsioses: typhus, spotted fever & other rickettsioses and newer classifications
Traditional bacterial diseases: plague, tularemia, relapsing fevers, the bartonelloses
Lyme disease, STARI, the erhlichioses
Protozoa:
Human malarias and babesiosis
Trypanosomiases (Chagas’ disease & African sleeping sickness)
The leishmaniases (Cutaneous, muco-cutaneous and visceral leishmaniasis)
Helminths:
Human and zoonotic filariases (W bancrofti. etc.)
Onchocerciasis, loa loa, and dracunculiasis
LIBRARY ASSIGNMENT
June 7
Food-water-milk-borne diseases
Intoxications:
Heavy metals: Zinc, lead, cadmium, arsenic, etc.
Organophosphates, other insecticides and pesticides
Bacterial: Botulism, C. perfringens, B. cereus, Staph, cholera
Plants: Alkaloids, glycosides, oils, lathyrism
Algae/fish, animals: Ciguatera, pufferish, pfeisteria, quail
Infections:
Bacterial: Salmonella, Typhoid, Shigella, E coli O157, Campylobacteriosis, Listeriosis, Vibrio (incl. cholera)
Viral: Norovirus, rotavirus, HAV, HEV
Infestations:
Protozoa: Ameba, cyclosporidiosis, cryptosporidiosis, giardiasis
Helminths:
Tapeworms (cestodes)
Roundworms (nematodes)
Flukes (trematodes)
LIBRARY ASSIGMENT
June 14
Mycobacteria
Tuberculosis: history, etiology, pathogenesis, diagnosis and treatment
Opportunist mycobacteria. The MAC complex
Atypical mycobacteria
Leprosy: history, etiology, pathogenesis, diagnosis and treatment
Johne’s disease and its relationship to Crohn’s disease
LIBRARY ASSIGMENT
June 21
Air-borne diseases of public health importance
Influenza: history, etiology, pathogenesis, diagnosis and treatment
Avian influenza and pandemic influenza
SARS
Legionellosis
LIBRARY ASSIGNMENT
June 28
Sexually transmitted diseases
The history of sexually transmitted diseases
Traditional “venereal diseases”:
Syphilis, gonorrhea, Chlamydia, LGV, GI, chancroid, lice
Other STDs: HBV, HPV, herpes, HCV
LIBRARY ASSIGNMENT
July 5
HIV/AIDS
The history of HIV
The HIV à AIDS progression, CD4 counts, viral load
Opportunistic infections: MAC, Candida, toxoplasmosis, cytomegalovirus, aspergillosis, etc.
Other non-HIV infections
LIBRARY ASSIGNMENT
MIDTERM MULTIPLE CHOICE EXAM: one hour
July 12
Animal-borne diseases of public health importance
Rabies and other lyssa viruses
Monkeypox and other zoonotic orthopox viruses
Hantaviral and arenaviral hemorrhagic diseases
Nipah and Hendra viral diseases; other new viral zoonoses
Cat scratch disease, glanders, leptospirosis, anthrax, brucellosis
BSE and chronic wasting disease and other zoonotic prion diseases
LIBRARY ASSIGNMENT
July 19
Nosocomial diseases (Guest speaker, Christopher Novak, MD)
Surveillance systems and classifications; organizational issues
MRSA, VRE, VRSA, ESBL, GAS, C. Difficile, RSV, etc.
Opportunistic organisms (Pseudomonas, Serratia, E coli, etc.)
Regulatory requirements, Isolation and Quarantine procedures
LIBRARY ASSIGNMENT
July 26
Immunizable diseases
Pediatric immunizable diseases:
MMR, DTaP, IPV, Hib, HBV, vaccinia, pneumococcal, rotavirus
Adult immunizable diseases:
Td, HAV, HBV, meningococcal, pneumococcal, influenza
Special immunizations:
Yellow fever, typhoid, smallpox, JBE, anthrax, cholera, etc.
LIBRARY ASSIGNMENT
Aug 1
Water/soil-borne diseases of public health importance
Protozoa:
Naegleria, acanthamoeba, cyclospora, cryptosporidia
Bacteria:
Tetanus, melioidosis, leptospirosis
Fungi:
Histoplasmosis, coccidioidomycosis, N.A. blastomycosis, S. A. blastomycosis, chromoblastomycosis, sporotrichosis
Roundworms:
Hookworm, CLM, VLM, strongyloidiasis, baylisascariasis
Flukes:
Schistosomiasis
LIBRARY ASSIGNMENT
AUG 8
FINAL EXAMINATION: 2 hours
Final presentation: An Epidemiological Analysis of the Ten Plagues of Egypt
Final discussion: An integration of many of the communicable diseases discussed in previous presentations and future trends
Required Texts:
Control of Communicable Disease Manual, 2004. The American Public Health Association
Suggested resource web sites:
Answers.com http://www.answers.com/
Epidemiology – Resources
Public Health, Biosciences: http://www.epibiostat.ucsf.edu/epidem/epidem.html#INF
Centers for Disease Control: http://www.cdc.gov/
CDC Prion Pathology: Center: http://www.cjdsurveillance.com/
CDC National Center for Infectious Diseases: http://www.cdc.gov/ncidod/index.htm
CDC Emerging Infectious Disease Journal: http://www.cdc.gov/ncidod/eid/index.htm
CDC MMWR Journal: http://www.cdc.gov/mmwr/
CDC Public Health Image Library: http://phil.cdc.gov/phil/default.asp
Medline dictionary: http://www.nlm.nih.gov/medlineplus/mplusdictionary.html
National Library Of Medicine: http://www.nlm.nih.gov/
National Parasite Collection Search: http://www.lpsi.barc.usda.gov/BNPCU/Parasrch.htm
NIAID web resources: http://www.niaid.nih.gov/default.htm
PubMED: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
ProMED: http://www.fas.org/promed/
Virginia Department of Health (Epidemiology): http://www.vdh.state.va.us/epi/newhome.asp
Virginia Tech Entomology Department: http://whizlab.isis.vt.edu/servlet/sf/ento//index.html
Waterborne diseases: http://www.waterhealthconnection.org/tableofcontents.asp
WHO Bulletin of World Health: http://www.who.int/bulletin/en/
