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