Epidemiological Concepts

  • Alfred S. Evans

Abstract

Epidemiology is the study of the determinants and distribution of health and disease in populations. (60a) It is a quantitative science concerned with the circumstances under which disease processes occur, the factors that affect their incidence and spread, and the use of this knowledge for prevention and control. (34) For infectious diseases, one must study the circumstances under which both infection and disease occur, for these may be different. Infection is the consequence of an encounter of a potentially pathogenic microorganism with a susceptible human host through an appropriate portal of entry. Exposure is the key factor, and the sources of infection lie mostly outside the individual human host within the environment or other infected hosts. Disease represents one of the possible consequences of infection, and the factors important in its development are mostly intrinsic to the host, although the dosage and virulence of the infecting microbe play a role.

Keywords

Typhoid Fever Genital Herpes Enteric Infection Foodborne Outbreak Epidemic Curve 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Barrett-Connor, E., Infectious and chronic disease epidemiology: Separate and unequal? Am. J. Epidemiol. 109:245–249 (1979)PubMedGoogle Scholar
  2. 2.
    Bellanti, J. A. (ed.), Immunology, W. B. Saunders, London, 1978.Google Scholar
  3. 3.
    Benacerraf, B., Suppressor T cells and suppressor factor, Hosp. Pract. 13 (4):65–75 (1978).PubMedGoogle Scholar
  4. 4.
    Benacerraf, B., and Unanue, E. R. Textbook of Immunology, Williams and Wilkins, Baltimore, 1979.Google Scholar
  5. 5.
    Benenson, A. S. (ed.), Control of Communicable Diseases in Man, 13th ed., An Official Report of the American Public Health Association, Washington, D.C., 1981.Google Scholar
  6. 6.
    Benner, E. J., and Hoeprich, P. D., Acute bacterial meningitis, in: Infectious Diseases (P. D. Hoeprich, ed.), pp. 931–944, Harper and Row, New York, 1972.Google Scholar
  7. 6a.
    Bennett, J. V., and Brachman, P. S. (eds.), Hospital Infections, Little, Brown, Boston, 1979.Google Scholar
  8. 7.
    Berger, S. A., Hazelh, N., and Weitzman, S., Prophylactic antibiotic in surgical procedures, Surg. Gynecol. Obstet. 146:469–475 (1978) .PubMedGoogle Scholar
  9. 7a.
    Blake, P. A., Allegra, D. T., Snyder, J. D., Barnett, T. J., Mcfarland, L., Caraway, C. T., Feeley, J. C., Craig, J. P., Lee, J. V., Puhr, N. D., and Feldman, R. A., Cholera-a possible endemic focus in the United States, N. Engl. J. Med. 302:305–309 (1980).PubMedCrossRefGoogle Scholar
  10. 8.
    Blake, P. J., and Perez, R. C., Applied Immunological Concepts, Appleton-Century-Crofts, New York, 1978.Google Scholar
  11. 8a.
    Boisert, P. L., Darrow, D. C., Powers, G. F., and Trask, J. D., Streptococcosis in Children, Am. J. Dis. Child 64:516–538 (1942).Google Scholar
  12. 9.
    Bodily, H. L., Updyke, E. L., and Mason, J. O. (eds.), Diagnostic Procedures for Bacterial, Mycotic, and Parasitic Infections, American Public Health Association, New York, 1970.Google Scholar
  13. 10.
    Centers for Disease Control, 68 National Nosocomial Infections, Study and Hospitals, 1970.Google Scholar
  14. 11.
    Centers for Disease Control, Shigellosis related to an airplane meal, Morbid. Mortal. Weekly Rep. 20:397–402 (1971).Google Scholar
  15. 12.
    Centers for Disease Control, Cholera, Morbid. Mortal. Weekly Rep. 21:392 (1972).Google Scholar
  16. 13.
    Centers for Disease Control, Diphtheria and tetanus toxoids and pertussis vaccine, Morbid. Mortal. Weekly Rep. 26:401–407 (1977).Google Scholar
  17. 14.
    Centers for Disease Control, Selected recommendations of the Public Health Service Advisory Committee on Immunization Practices: Collected recommendations on routine childhood vaccines, Morbid. Mortal. Weekly Rep. 26:401–402, 407, 444 (1977).Google Scholar
  18. 15.
    Centers for Disease Control, Cholera Vaccine, Morbid. Mortal. Weekly Rep. 27:173–174 (1978).Google Scholar
  19. 16.
    Centers for Disease Control, Typhoid vaccine, Morbid. Mortal. Weekly Rep. 27:231–233 (1978).Google Scholar
  20. 17.
    Centers for Disease Control, Plague vaccine, Morbid. Mortal. Weekly Rep. 27:255–258 (1978).Google Scholar
  21. 18.
    Centers for Disease Control, Meningococcal polysaccharide vaccines, Morbid. Mortal. Weekly Rep. 27:327–329 (1978).Google Scholar
  22. 19.
    Centers for Disease Control, Reported morbidity and mortality in the United States, 1978, Morbid. Mortal Weekly Rep. (Suppl.) 27(54):1–94 (1979).Google Scholar
  23. 20.
    Centers for Disease Control, Health information for international travel, 1979, Morbid. Mortal. Weekly Rep. (Suppl.) 28:1–102 (1979).Google Scholar
  24. 20a.
    Centers for Disease Control, Nonreported sexually transmissible diseases-United States, Morbid. Mortal. Weekly Rev. 28:61–63 (1979).Google Scholar
  25. 20b.
    Centers for Disease Control, Isolation techniques for use in hospitals, Phs Publication No. 2054, 1970.Google Scholar
  26. 20c.
    Centers for Disease Control, National nosocomial infections study report (Nov. 1979).Google Scholar
  27. 21.
    Cho, C. T., and Dudding, B. A., Pediatric-Infectious Diseases, Medical Examination Publishing, Garden City, New York, 1978.Google Scholar
  28. 22.
    Davidson, G. P., Bishop, R. F., Townley, R. R. W., Holmes, I. H., and Ruck, B. J., Importance of a new virus in acute sporadic enteritis in children, Lancet 1:242–246 (1975).PubMedCrossRefGoogle Scholar
  29. 23.
    Denny, F. W., Clyde, W. A., Jr., and Glezen, W. P., Mycoplasma pneumoniae disease: Clinical spectrum, pathophysiology, epidemiology, and control, J. Infect. Dis. 123:74–92 (1971).PubMedCrossRefGoogle Scholar
  30. 24.
    Diamantstein, T., Oppenheim, J. J., Unanue, E. R., Wood, D. D., Handschumacher, R. E., Rosenstreich, D. L., and Waksman, B. H., Nonspecific&#x201Clymphocyte activating&#x201C factors produced by macrophages, Clin. Immunol. Immnunopathol. 14:264–267 (1979).CrossRefGoogle Scholar
  31. 25.
    Drachman, R. H., Acute infectious gastroenteritis, Pediatr. North Am. Clin. 25:711–741 (1978).Google Scholar
  32. 26.
    Dupont, H. L., Enteropathogenic organism, new etiologic agent and concepts of disease, Med. Clin. North Am. 62:945–960 (1978) .PubMedGoogle Scholar
  33. 27.
    Dupont, H. L., Sullivan, P., Evans, D. G., Pickering, L. K., Evans, D. J., Vollet, J. J., Ericsson, C. D., Ackerman, P. B., and Tjoa W. S., Prevention of traveler’s diarrhea (emporiatric enteritis), J. Am. Med. Assoc. 243:237–271 (1980).CrossRefGoogle Scholar
  34. 27a.
    Evans, A. S., Clinical syndromes in adults caused by respiratory infection, Med. Clin. North Am. 51 (3):803–818 (1967).PubMedGoogle Scholar
  35. 28.
    Evans, A. S., New discoveries in infectious mononucleosis, Mod. Med. 42:18–24 (1974).Google Scholar
  36. 29.
    Evans, A. S., Diagnosis and prevention of common respiratory infections, Hosp. Med. 10:31–41 (1974).Google Scholar
  37. 30.
    Evans, A. S. (ed.), Viral Infections of Humans: Epidemiology and Control, 2nd ed., Plenum Medical, New York, 1982.Google Scholar
  38. 31.
    Evans, A. S., Causation and disease: The Henle-Koch Postulates revisited, Yale J. Biol. Med. 49:175–195 (1976).PubMedGoogle Scholar
  39. 32.
    Evans, A. S., Limitation of Koch’s postulates (letter to the editor), Lancet 2:1277–1278 (1977).PubMedCrossRefGoogle Scholar
  40. 33.
    Evans, A. S., Causation and disease: A chronological journey, Am. J. Epidemiol. 108:249–258 (1978).PubMedGoogle Scholar
  41. 34.
    Evans, A. S., Re: Definitions of epidemiology (letter), Am. J. Epidemiol. 109:379–381 (1979).PubMedGoogle Scholar
  42. 35.
    Evans, A. S., Allen, V., and Sueltmann, S., Mycoplasma pneumoniae infections in University of Wisconsin students, Am. Rev. Respir. Dis. 96:237–244 (1967).PubMedGoogle Scholar
  43. 36.
    Evans, A. S., and Dick, E. C., Acute pharyngitis, tonsillitis in University of Wisconsin students, J. Am. Med. Assnc. 190:699–708 (1964).CrossRefGoogle Scholar
  44. 37.
    Fedson, D. S., and Rusthoven, J., Acute lower respiratory disease, Primary Care 6:13–41 (1979).PubMedGoogle Scholar
  45. 37a.
    Fiumara, N. J., The sexually transmissible diseases, Dis.-Mon. 25:3–38 (1978).Google Scholar
  46. 38.
    Fox, J. D., Family-based epidemiologic studies: The second Wade Hampton Frost lecture, Am. J. Epidemiol. 99:165–179 (1974).PubMedGoogle Scholar
  47. 39.
    Foy, H. M., Grayston, J. T., Kenny, G. E., Alexander, E. R., and Mcmahan, R., Epidemiology of Mycoplasma pneumoniae infection in families, J. Am. Med. Assoc. 197:859–866 (1966) .CrossRefGoogle Scholar
  48. 40.
    Glezen, W. P., Clyde, W. A., Senior, R. J., Scheaffer, C. I., and Denny, F. W., Group A streptococci, mycoplasmas, and viruses associated with acute pharyngitis, J. Am. Med. Assoc. 202:455–460 (1967).CrossRefGoogle Scholar
  49. 41.
    Glorig, A., and Ger, K. S., Otitis Media, Charles C. Thomas, Springfield, Illinois, 1972.Google Scholar
  50. 42.
    Gorbach, S. L., and Khurana, C. M., Toxigenic Escherichia coli: A cause of infantile diarrhea in Chicago, N. Engl. J. Med. 287:791–797 (1971).CrossRefGoogle Scholar
  51. 43.
    Handsfield, H. H., Gonorrhea and non-gonococcal urethritis: Recent advances, Med. Clin. North Am. 62:925–943 (1978).PubMedGoogle Scholar
  52. 44.
    Helstad, A. G., Mandel, A. D., and Evans, A. S., Thermostable Clostridium perfringens as cause of food poisoning outbreak, Public Health Rep. 82:157–161 (1967).PubMedCrossRefGoogle Scholar
  53. 45.
    Henle, J., On Miasmata and Contagie, Johns Hopkins Press, Baltimore, 1938 (translated and with an introduction by G. Rosen).Google Scholar
  54. 46.
    Hoeprich, P. D., Chemoprophylaxis of infectious diseases, in: Infectious Diseases, 2nd ed. (P. D. Hoeprich, ed.), pp. 190–206, Harper and Row, New York, 1977.Google Scholar
  55. 47.
    Hoeprich, P. D. (ed.), Infectious Diseases, 2nd ed., Harper and Row, New York, 1977.Google Scholar
  56. 48.
    Holmes, K. K., and Stamm, W. E., Chlamydial genital infections: A growing problem, Hosp. Pract. 14:105–117 (1979).PubMedGoogle Scholar
  57. 49.
    Hood, L. E., Weissman, I. L., and Wood, W. B., Immunology, Benjamin/Cummings, Reading, Massachusetts, 1978.Google Scholar
  58. 50.
    Huebner, R. J., The virologist’s dilemma, Ann. N.Y. Acad. Sci. 67:430–445 (1957) .PubMedCrossRefGoogle Scholar
  59. 51.
    Jawetz, E., Melnick, J. L., and Adelberg, E. A., Re view of Medical Microbiology, 13th ed., Lange, Los Altos, California, 1978.Google Scholar
  60. 51a.
    Johnson, R. T., and Gibbs, C. J., Jr., Editorial: Koch’s postulates and slow infections of the nervous system, Arch. Neurol. 30:36–38 (1974).PubMedCrossRefGoogle Scholar
  61. 52.
    Jupa, J. E., Venereal disease, Primary Care 6:113–126 (1979).PubMedGoogle Scholar
  62. 53.
    Kallman, F. J., and Reisman, D., Twin studies on the significance of genetic factors in tuberculosis, Am. Rev. Tuberc. 47:549–574 (1943).Google Scholar
  63. 54.
    Knight, V. (ed.), Viral and Mycoplasma Infections of the Respiratory Tract, Lea and Febiger, Philadelphia, 1973.Google Scholar
  64. 55.
    Koch, R., Die Aetiologie der Tuberculose, Berlin Klin. Wochn. 19:221–230 (1882).Google Scholar
  65. 56.
    Koch, R., Ueber bacteriologische Forschung, in: Verhandlungendes X Int. Med. Cong. Berlin, 4–9 Aug., 1890, p. 35, Verlag von August Hirschwald, Berlin 1892.Google Scholar
  66. 56a.
    Langmuir, A. D., and Gangarosa, E. J., Practical outline of major forms of enteric disease, Presented at the Iea Regional Scientific Meeting on Enteric Infections, Alexandria, Egypt, May 27–31 (1978).Google Scholar
  67. 57.
    Lennette, E. H., and Spaulding, J. P. (eds.), Manual of Clinical Microbiology, 2nd ed., American Society for Clinical Microbiology, Bethesda, Maryland, 1974.Google Scholar
  68. 58.
    Lilienfeld, A. M., The epidemiologic method in cancer research, J. Chron. Dis. 8:647–654 (1958).Google Scholar
  69. 59.
    Lilienfeld, A. M., Fundamentals of Epidemiology, Oxford University Press, New York, 1976.Google Scholar
  70. 60.
    Lilienfeld, D. E., Definitions of epidemiology, Am. J. Epidemiol. 107:87–90 (1978).PubMedGoogle Scholar
  71. 60a.
    Macmahon, B., and Pugh, T. F., Epidemiology, Principles and Methods, Little, Brown, Boston, 1970.Google Scholar
  72. 61.
    Maxy, K. G., and Roseneau, M. J., Preventive Medicine and Public Health (P. E. Sartwell, ed.), Appleton-Century-Crofts, New York, 1965.Google Scholar
  73. 62.
    Mcallister, T. A., Percival, A., Alexander, J. G., Boyce, J. M. H., Dulake, C., and Wormald, P. J., Multicentric study of sensitivities of urinary tract pathogens, Postgrad. Med. J. (Sept. Suppl.) 47:7–14 (1971).PubMedGoogle Scholar
  74. 63.
    Mccormack, W. M., Sexually transmissable diseases, Postgrad. Med. 58:179–186 (1975).PubMedGoogle Scholar
  75. 64.
    Mccormack, W. M., Viral, fungal, parasitic, and other sexually transmitted infections, Forum Infect. 4:3–22 (1977) .Google Scholar
  76. 65.
    Mims, C. A., The Pathogenesis of Infectious Disease, Academic Press, London/Grune and Stratton, New York, 1976.Google Scholar
  77. 66.
    Powers, G. F., and Boisvert, P. L., Age as a factor in streptococcus, J. Pediatr. 25:481–509 (1944).CrossRefGoogle Scholar
  78. 67.
    Price, D. L., Tetanus toxin: Direct evidence for retrograde intraaxonal transport, Science 188:945–947 (1975).PubMedCrossRefGoogle Scholar
  79. 68.
    Reimann, H. M., The Pneumonias, Warner H. Green, St. Louis, 1971.Google Scholar
  80. 69.
    Rivers, T. M., Viruses and Koch’s postulates, J. Bacteriol 33:1–12 (1937).PubMedGoogle Scholar
  81. 70.
    Roit, I. M., Essential Immunology, 2nd ed., Blackwell, Oxford, 1974.Google Scholar
  82. 71.
    Seto, D. W. Y., and Heller, R. M., Acute respiratory infections, Pediatr. Clin. North Am. 21:683–709 (1974).PubMedGoogle Scholar
  83. 71a.
    Sours, H. E., and Smith, D. G., Outbreaks of foodborne diseases in the United States, 1972–1978, J. Infect. Dis. 141:122–125 (1980).CrossRefGoogle Scholar
  84. 72.
    Tillotson, J. R., and Finland, M., Bacterial colonization and clinical superinfection of the respiratory tract complicating antibiotic treatment of pneumonia, J. Infect . Dis. 119:597–524 (1969) .PubMedCrossRefGoogle Scholar
  85. 73.
    Tosato, G., Magrath, I., Koski, I., Dooley, N., and Blaese, M., Activation of suppressor T cells during Epstein-Barr-virus-induced infectious mononucleosis, N. Engl. J. Med. 301:1133–1137 (1979).PubMedCrossRefGoogle Scholar
  86. 74.
    Veterans Administration Ad Hoc Interdisciplinary Advisory Committee on Antimicrobial Drug Usage (C. Kunin, chairman), Audit of antimicrobial usage: Prophylaxis in surgery, J. Am. Med. Assoc. 237:1003–1008 (1977) .Google Scholar
  87. 75.
    Wehrle, P. F., Meningitis, in: Communicable and Infectiou Diseases (F. H. Top, Sr., And P. F. Wehrle, eds.), pp. 436–453, C. V. Mosby, St. Louis, 1976.Google Scholar
  88. 76.
    Wing, E. J., and Remington, J. S., Cell-mediated immunity and its role in resistance to infection (medical progress), West. J. Med. 126:14–31 (1977).PubMedGoogle Scholar
  89. 77.
    Yolken, R. H., Wyatt, R. G., Zissis, G., Brandt, C. D., Rodriguez, W. J., Kim, H. W., Parrott, R. H., Urrutia, J. J., Mata, L., Greenberg, H. B., Kapikian, A. Z., and Chanock, R. M., Epidemiology of human rotavirus types 1 and 2 as studied by enzyme-linked immunosorbent assay, N. Engl. J. Med. 299:1156–1161 (1978).PubMedCrossRefGoogle Scholar
  90. 78.
    Zinkernagel, R. M., Major transplantation antigens in host responses to infection, Hosp. Pract. 13:83–92 (1978).PubMedGoogle Scholar

Suggested Reading

  1. Benenson, A. S. (ed.), Control of Communicable Diseases in Man, 13th ed., American Public Health Association, Washington, D.C., 1981.Google Scholar
  2. Evans, A. S. (ed.), Viral Infections of Humans: Epidemiology and Control, 2nd ed., Plenum Medical, New York, 1982.CrossRefGoogle Scholar
  3. Hoeprich, P. D. (ed.), Infectious Diseases, Harper and Row, Hagerstown, 1972.Google Scholar
  4. Jawetz, E., Melnick, J. L., and Adelberg, E. A. (eds.), Medical Microbiology, 13th ed., Lange Medical Publications, Los Altos, California, 1978.Google Scholar
  5. Mandell, G. L., Douglas, R. G., Jr., and Bennett, J. E. (eds.), Principles and Practice of Infectious Diseases, John Wiley & Sons, Vol. 1 and 2, New York, 1979.Google Scholar
  6. Mims, C. A., The Pathogenesis of Infectious Disease, Academic Press, London/Grune & Stratton, New York, 1976.Google Scholar
  7. Wehrle, P. F., and Top, F. H., Sr., Communicable and Infectious Diseases, 9th ed. The C. V. Mosby Company, St. Louis, 1981.Google Scholar

Copyright information

© Springer Science+Business Media New York 1982

Authors and Affiliations

  • Alfred S. Evans
    • 1
  1. 1.WHO Serum Reference Bank, Section of International Epidemiology, Department of Epidemiology and Public HealthYale University School of MedicineNew HavenUSA

Personalised recommendations