Readyset Go Epidemio Mbbs

Theory of “Web of causation”
• Epidemiological triad could not explain the

causation of non communicable disease
• IHD(Ischemic HeartDisease) and road
accidents cannot be explain by single agent
• Interaction of multiple factor leads to pre
pathogenic phase and later to full blown
disease
Theory of “Web of causation”
• McMahon and Colleagues forwarded the
theory
• Various factor Interact as web of a spider,
modifying the effect of each other in
causation of disease
• theory helps in preventing by attacking the
weakest links in the web
Changes in life style
Epidemiological wheel theory
• Comparative role of genetic and
environmental factor in causation of disease
• Web and triad theory do not cover this aspect
• Relative contribution of genetic and
environmental factor, wheel theory was
postulated
Epidemiological wheel theory
• Visualized in the form of wheel
• Central hub represent genetic component
• Peripheral portion – environment
• Outer part is divided into sub groups by pokes
– Social
– Biological
– Physical
Epidemiology
I keep six honest men; they taught me all I know.

Their names are what, why, when, how, where,
who.”
Dr.Leela Paudel
MBBS,MD
Books to read
What is epidemiology?
• The study of how the disease is distributed in
Populations.
• The factors that determine or influence this

distribution.
• Why does a disease develop in some people

and not in others?
Epidemiology
EPI DEMOS
LOGOS
Upon, People, population, man the Study of
The study of anything that happens to

people
“Study among the population”
Essay on Malaria
• Malaria is caused by a parasite called Plasmodium.
• It is transmitted by bite of female anopheles
mosquito. It manifests as acute febrile illness with
chills and rigors.
• In our country 2-3 in 10000 people are likely to get
malaria every year.
• It is more common among children, poor people,
foreigners, immunocompromised people.
• It is common in Terai region, urban slums but not in
hilly areas.
Essay on Malaria
• Malaria can be prevented by spraying insecticides on
water collections and on the walls of our houses.
• It can be diagnosed by a simple blood test and can be

treated effectively by oral Chloroquin and Primaquin.
The above facets put together is called as “Epidemiology”
Epidemiology
What does the brief history about
epidemiology teach us?
• Community and environment influence of

health of humans
• Knowing how a disease is transmitted permits

us to prevent and control it even if we do not
know the cause.
What does the brief history about
epidemiology teach us?
• Simplest information about vital events,

illness and populations can detect and
analyze epidemiological problems.
• Epidemiology can help find, investigate,

analyze, control, and prevent a wide range of
health problems.
Terminologies
Communicable disease :
• An illness due to a specific infectious agent
or its toxic products capable of being
directly or indirectly transmitted from
man to man, animal to animal, or from the
environment( through air, dust ,soil,
water, food etc.) to man or animal.
Communicable disease:
An illness due to specific infectious agent or its
toxic products capable of being directly or
indirectly transmitted from man to man,
animal to animal, or from environment to
man or animal
Contagious disease:
A disease that is transmitted through contact
- STD, Scabies, leprosy
Infection:
• The entry and development or multiplication of an
infectious agent in the body of man or animal. An
infection doesn't always cause illness.
Infestation:
• Presence or lodgement of living infectious agent on
exterior surface of the body, e.g. pediculosis,
scabies.
• For persons or animals the lodgement, development
and reproduction of arthopods on the surface of the
body or in the clothing, e.g., lice, itch mite
Contamination:
• The presence of an infectious agent on a body surface;
also on or in clothes, bedding, toys, surgical
instruments or dressings, or other inanimate articles or
substances including water, milk and food.
• Pollution is distinct from contamination and implies

the presence of offensive but not necessarily infectious
matter in the environment.
Incubation Period:
The time interval between invasion by an

infectious agent and appearance of the
first sign or symptom of the disease
Latent period:
The delay between exposure to a disease-
causing agent and the appearance of
manifestations of the disease.
Infectivity:
• Ability of micro-organism to invade and multiply in
the host
Pathogenicity :
• Ability to produce illness or disease
• ability of a microbe to cause disease or damage to its
host
Virulence:
• Ability to produce severity and fatality
• Proportion of clinical cases resulting in severe clinical
manifestation
• the severity of the damage each microbe can cause is
referred to as its virulence.
Host:
• person or animal, including birds and arthropods that
affords subsistence or lodgement to an infectious agent
under natural conditions.
Types:
• Obligate host- the only host, e.g., man in measles &
typhoid
• Primary or definitive- host in which parasite attains
maturity or passes its sexual stage. Mosquito in
malaria, JE; man in filariasis
• Secondary or intermediate host- host in which a
parasite passes one or more of its asexual stage.
Man in malaria and mosquito in filariasis
• Transport host- host that carries parasites but the
parasites does not undergo development
Vector:
• An insect or any living carrier that
transports an infectious agent from an
infected individual or to a susceptible
individual or its food or immediate
surroundings. The organism may or may
not pass through a developmental cycle
within the vector
• For eg. Mosquito vector for malaria,
dengue etc.
Opportunistic infection:
• It is the infection with organism/s that are
normally innocuous, but become pathogenic
when the body's immunologic defences are
compromised.
• Iatrogenic (physician-induced) disease: Illness
resulting from a physician's professional
activity or from the professional activity of
other health professionals.
• Due to the activity of a physician or therapy. For
example, an iatrogenic illness is an illness that is
caused by a medication or physician.
• For example, radiation therapy and chemotherapy —

frequently produce such iatrogenic effects as hair loss,
hemolytic anemia, diabetes insipidus, vomiting, nausea,
brain damage, lymphedema, infertility, etc.
Nosocomial infection (hospital-acquired
infection):
• Nosos=disease; nosocomial=relating to hospital.
These are cross infections occurring in the
hospitals.
• HAI are defined as acquiring an infection in the
hospital by the patients or others during their stay
and manifesting either during the hospital stay
itself or after discharge.
• Cause: failure to observe aseptic precautions
while carrying out the hospital procedures such as
surgical operation, dressing of the wounds, giving
injection etc.
Endemic
• The habitual presence of a disease within a given
geographic area
• May also refer to the usual prevalence of a given
disease within such an area
• Endemic is the constant or usual presence of a

disease or infectious agent within a given
geographical area or a population without
importation from outside. For e.g common cold
Epidemic:
The unusually occurrence in a community
or region of disease, specific health related
behaviour or health related events clearly in
excess of expected occurrence
• Outbreak: a sudden occurrence, small,

usually localized epidemic in the interest
of minimizing public alarm,
unless the number
of cases is indeed very large
Pandemic :
• Usually occurring over a very wide area,
crossing international boundaries and
usually affecting a large number of people.
Sporadic:
• The disease occurring irregularly,
haphazardly from time to time, and
generally infrequently. Example: polio,
tetanus, herpes zoster
Exotic:
• The disease, which is imported into a
country in which they do not otherwise
occur. Example: Rabies in UK.
zoonoses
• An infectious disease transmissible under

natural conditions from vertebrate animals
to man
• -T. solium, T.saginnata, bovine TB, plague,
rabies, JE
Epizootic:
An epidemic of disease in an animal population
(often with the implication that it may also affect
human populations).
Epornithic:
• An outbreak (epidemic) of disease in a bird
population.
Enzootic:
• An endemic occurring in animals
Surveillance
• Surveillance means to watch over with great
attention, authority and often with suspicion
• Surveillance is defined as "the continuous

scrutiny (inspection) of the factors that
determine the occurrence and distribution of
disease and other conditions of ill-health"
Fomite:
• Inanimate articles or substance other than water
or food contaminated by the infectious discharges
from a patient and capable of harbouring and
transferring the infectious agent to a healthy
person
• Includes, soiled cloths, towels, handkerchiefs,

cups, spoons, pencils, taps, syringes, books etc
Isolation:
• Separation, for the period of
communicability of infected persons or
animals from others in such places and
under such conditions as to prevent or limit
the direct or indirect transmission of the
infectious agent from those infected to
those who are susceptible or who may
spread the agent to others
Quarantine:
• Restriction of the activities of well persons
or animals who have been exposed to a
case of communicable disease during its
period of communicability (i.e. contacts) to
prevent disease transmission during the
incubation period if infection should occur.
• Isolation is done for sick person and quarantine is
done for apparently health person
Sterilization:
• The process of destroying all life including spores.
• Widely use in medical practice
Disinfection:
• The killing of infectious agents outside the body
by direct exposure to chemical or physical agents
Contd…
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Readyset Go Epidemio Mbbs

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Theory of “Web of causation”

• Epidemiological triad could not explain the

I keep six honest men; they taught me all I know.

• The factors that determine or influence this

• Why does a disease develop in some people

The study of anything that happens to

• It can be diagnosed by a simple blood test and can be

• Community and environment influence of

• Knowing how a disease is transmitted permits

• Simplest information about vital events,

• Epidemiology can help find, investigate,

• Pollution is distinct from contamination and implies

The time interval between invasion by an

• For example, radiation therapy and chemotherapy —

• Endemic is the constant or usual presence of a

• Outbreak: a sudden occurrence, small,

• An infectious disease transmissible under

• Surveillance is defined as "the continuous

• Includes, soiled cloths, towels, handkerchiefs,

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