Summary of infectious disease epidemiology course

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1 Summary of infectious disease epidemiology course Mads Kamper-Jørgensen Associate professor, University of Copenhagen, Public health science 3 December 2013 Slide number 1

2 Aim Possess knowledge of frequent infectious diseases in Denmark Account for and calculate infectious disease frequency and association measures Be familiar with outbreak investigation, vaccination schedules, and infectious disease surveillance in Denmark Be familiar with challenges related to statistical analysis of infectious disease data Know of real-world infectious disease epidemiologic work in Denmark Public health science 3 December 2013 Slide number 2

3 Introduction Infectious disease history and future in Denmark Infectious, communicable, transmissible and contagious diseases Epidemic, pandemic, and endemic state Incubation, infectious and latent period Case-fatality, attack and basic reproductive rate (R 0 ) Public health science 3 December 2013 Slide number 3

4 Measures Transmission chain, severity and course of the infection Incidence (cumulative), prevalence (point and period) Point source, propagated spread Effective reproductive number SIR modelling Absolute, relative and attributable risk Odds ratio Confounding Public health science 3 December 2013 Slide number 4

5 Infectious diseases Bacteria, viruses, fungi, protozoa Portal of entry: resp., gast., urogenit., skin Routes of transmission: person to person, air, food, water, insects, fomites Bacterial infections are treated with antibiotics Big 3 bacterial sexual communicable diseases: chlamydia, gonorrhea, syphilis 4xH viral sexual communicable diseases: herpes, HPV, hepatitis B, HIV The 3 (+2) global killers: HIV, TB, malaria, diarrhea, pneumonia Individual and global prevention Public health science 3 December 2013 Slide number 5

6 Surveillance Ongoing, systematic, analysis, interpretation, outcome-specific, timely dissemination, prevention and control Trends, outbreaks, evaluate control, document distribution and spread, natural history, generate hypotheses, facilitate planning Indicator vs. event-based, passive vs. active, clinical vs. laboratory, sentinel Surveillance vs. research study Prioritizing control: frequency, severity, cost, preventability, communicability, interest, international relevance Imperfectness of data, but for action Public health science 3 December 2013 Slide number 6

7 Outbreaks An outbreak is more cases than expected in a specific area, population or period Confirm outbreak Confirm diagnosis Case definition Identify cases and obtain information Describe data Develop hypothesis Analytical study Implement control Communicate results Public health science 3 December 2013 Slide number 7

8 Analysis Infectious disease data is often correlated If correlated within individuals, the standard error becomes too large If correlated between individuals, the standard error becomes too small Infectious disease data are often non-normal Assess the fit of your model Poor fit may reflect correlated data Possible solutions include random effects models, GEE models, over-dispersion parameter Public health science 3 December 2013 Slide number 8

9 Vaccination Vaccine component, adjuvant, preservatives Injection, oral, intranasal High-risk groups or routine vaccination Herd immunity Efficacy vs. effectiveness Prioritizing vaccination: seriousness of disease, effectiveness, safety, cost-effectiveness, sideeffects, interaction with other vaccines, ethics, long-term consequences, monitoring, coverage Public health science 3 December 2013 Slide number 9

10 Site visit Mads Melbye, vice president Henrik Hjalgrim, infections and cancer Marin Ström, POPs and neurodevelopment Signe Sørup, non-specific vaccine effects Maria Harpsøe, weight gain and infections Peter Bager, worm infections and allergy Public health science 3 December 2013 Slide number 10

11 Evaluation Transition from written to oral evaluation What worked, what did not work, suggestions for improvements Oral evaluation, who will help take notes? You: participation, preparedness, different backgrounds, class attendance Us: labs, teachers, format, level, literature, duration, communication, exam, unnecessary subjects, missing subjects, breaks, language Written evaluation sent to you by mail Public health science 3 December 2013 Slide number 11

12 Exam 4-hour written PC-exam Erasmus mundus students on December 10th from 9-13 All others on January 14th from 9-13 Aids not allowed: internet access, your own computer and calculator, cell phone Use the calculator in Windows, Microsoft software Yesterday you should have received a detailed exam letter by mail 11 questions with a total maximum of 100 points 50 points to pass Public health science 3 December 2013 Slide number 12

13 Exam Short introduction followed by 2-4 questions When preparing focus on the course notes, but read the text book Graded according to 7-point scale Results and answers available on January 7th. Results in Absalon and answers at Exam related questions to Anja Nordahl-Horn telephone Teaching related comments and questions to me at For all to see Public health science 3 December 2013 Slide number 13

14 Best of luck and happy holidays Public health science 3 December 2013 Slide number 14

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