Module 4: Epidemiology InvestigationEpidemiology Investigation

1) : « L’ouverture d’un EPI LCA dans le ours du yle 4, à quelque niveau que e soit et de quelque durée qu’il soit, rend possile la mise en plae de l’enseignement de complément à partir de la 5ème Dans ces conditions, tout élève qui suivra à quelque moment que ce soit de son cycle un EPI LCA peut bénéficier de cet enseignement

EPI – Langues et cultures de lAntiquité Rappels

5e et 2 heures en 4e et 3e (26+2 EDT) A ce titre, pour bénéficier de cet enseignement, les élèves doivent suivre un EPI-LCA (langues et cultures de l'Antiquité) en 5e, 4e et 3e Cet EPI est qualifié de déclencheur puisqu'il ouvre la voie à l'enseignement de complément Les EPI, enseignements pratiques interdisciplinaires, doivent :

Module 4: Epidemiology InvestigationEpidemiology Investigation

2 www adph org/epi Estimated Percents of Foodborne Illnesses in U S , 2011 4 Norovirus 58 Staph aureus 3 other 9 Salmonella 11 Clostridium perfringens

Epidemiology, by Example

epi demos logos + + + Upon People Study literally meaning "the study of what is upon the people" Joshua Naranjo Epidemiology, by Example Introduction Types of studies

Epidemiologic Study Designs - Hopkins Medicine

Epidemiologic Study Designs Jacky M Jennings, PhD, MPH Associate Professor Associate Director, General Pediatrics and Adolescent Medicine Director, Center for Child & Community Health Research (CCHR)

EPI Langues et cultures de l’Antiquité

cyclE I EPI I 4 LA L TURES L ’ANTIQUITÉ Français / anglais / lca (latin) tEmPoralIté DE l’EPI Le projet s’inscrit sur l’année scolaire : il peut fonctionner à raison d’une à deux heures par semaine Les séances sont prises en charge par les enseignants engagés dans le projet, en parallèle ou en co-intervention

Outbreak Case Definitions

Examples of a case definition: "Student attending X High School who has onset of fever and cough between January 4 and 24, 2007 "

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EPI Case Study 1: Incidence, Prevalence, and Disease Surveillance; Historical Trends in the Epidemiology of M tuberculosis Estimated Time to Complete Exercise: 30 minutes LEARNING OBJECTIVES At the completion of this Case Study, participants should be able to:

Pistes pédagogiques pour concevoir un EPI « Langues et

un enrichissement en EPI LCA de thèmes ou d’œuvres étudiés par le collègue en cours de Français (lecture de textes antiques, explorations lexicales, étymologiques, mythologiques, culturelles, historiques, réalisation d’une mise en scène, ou d’une

FORMATION DISCIPLINAIRE Langues et cultures de l’Antiquité

• 1h d’EPI LCA pour les élèves, mais 2h professeurs dont 1h prise sur la marge de 2h45 Intervention du professeur de LC par quinzaine Intervention en classe entière • L’enseignant de LC intervient sur un créneau en alternance avec le collègue d’une autre discipline une semaine sur deux • 1h d’EPI LCA pour les élèves, ½

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1

Module 4:

Epidemiology InvestigationEpidemiology Investigation

Epidemiology Division

Analysis and Reporting Branch

www.adph.org/epi

Module Learning Objectives

Develop a case definition

Explain an epidemic curve

Develop an initial hypothesis

List three types of study design and a method of

2 statistical analysis

Calculate measures of association

Interpret significance of data

Determine if hypotheses are confirmed or

rejectedwww.adph.org/epi

Estimated Annual U.S. Foodborne

Disease Burden, 2011

Foodborne Illnesses

48 million

Hospitalizations

128,000

Deaths

3,000 Source: http://www.cdc.gov/foodborneburden/2011-foodborne-estimates.html#annual 2 www.adph.org/epi

Estimated Percents of Foodborne

Illnesses in U.S., 2011

Norovirus

58%

Staph. aureus

3%other

Salmonella

11%Clostridium

perfringens

10%Campylobacter

9% www.adph.org/epi

Salmonellosis

56%

Cryptosporidiosis

6%E.coli (STEC)

Other *

1%5

AL 2011 Reported Diseases

Total = 2,260

Individual norovirus

cases are not

Shigellosis

14%

Campylobacteriosis

12%Giardiasis

8% * Incudes Hep A, HepE, Listeriosis, and Vibriosis reportable to EPI, just if part of an outbreak www.adph.org/epi

SalmonellaOutbreak Timeline

Example

SMT WThFS

PatientEats

Contaminated

FoodBecomesIllVisits

Doctor

(Stool

Sample

Incubation timeDelay seeking

medical care

Source: CDC

Collected)

Salmonella

identifiedPublic

Health

receives sample

Serotyping

andDNA fingerprintingCase

Confirmed

asPartof

Outbreak

Specimen delivered

and growing

Uploaded

3 www.adph.org/epi

When two or more persons (from different

households) experience a similar illness resulting from the ingestion of a common food.

AL Foodborne Outbreak

(FBO) Definition 7 from the ingestion of a common food.

Exceptions: botulism and chemical poisoning

(1 case = outbreak) www.adph.org/epi

Make Epidemiologic Associations

Person, place, time

Systematically organize key information

Develop initial hypothesis

www.adph.org/epi Agent • Recently recognized pathogens • New FB modes of transmission

Foodborne Illness: Changing

Epidemiology

9 Host • Increasing elderly, immunocompromised • New eating habits • Increasing immigration, international travel

Environment

• Globalization of food supply • Centralization of food processing, large producers 4 www.adph.org/epi

Develop Initial Case Definition:

Counting Apples and Oranges

Set of criteria for deciding whether an individual should be classified as "a case"

Objective criteria

10 j

Links person to place and time

Outbreak-associated vs.normal background

Value of routine surveillance data

Primary vs.secondary cases

www.adph.org/epi

Revise Case Definitions

Precise definitions reduce

potential for misclassification:

Estimated 41% of enteric infections in U.S.

are foodborne; 11

Incomplete case history can haunt you;

Incorrectly classifying individuals can bias

results;

Make it harder to detect true associations.

www.adph.org/epi

Person: AL Outbreak Examples

12 5 www.adph.org/epi

Place: Common Exposure Location

Case 1 - restaurants A, B, C, D

Case 2 - restaurants B, C, E, F

Case 3 - restaurants A, B, G, H, I

Case 4 -restaurants B, J, K

What is the common exposure location?

www.adph.org/epi

Place: Common Exposure

Location (cont.)

Restaurant

Single restaurant location

Multiple restaurants (chain or same owner)

Multiple chains with a common distributor

Banquets, Birthday Parties, Wedding

Receptions, Conferences, Basketball Game,

School Field Trip, Summer Camp, etc.

www.adph.org/epi

Point-Source Exposure

15 6 www.adph.org/epi

Ongoing Exposure

16 www.adph.org/epi

Propagated or Person-to-Person

17 www.adph.org/epi

Hypothesis

18 "An unproved theory ...tentatively accepted to explain certain facts or to provide a basis for further investigation"provide a basis for further investigation

[PDF] Module 4: Epidemiology InvestigationEpidemiology Investigation

Module 4:

Epidemiology Division

Analysis and Reporting Branch

Module Learning Objectives

Develop a case definition

Explain an epidemic curve

Develop an initial hypothesis

List three types of study design and a method of

Calculate measures of association

Interpret significance of data

Determine if hypotheses are confirmed or

Estimated Annual U.S. Foodborne

Disease Burden, 2011

Foodborne Illnesses

48 million

Hospitalizations

128,000

Deaths

Estimated Percents of Foodborne

Illnesses in U.S., 2011

Norovirus

Staph. aureus

3%other

Salmonella

11%Clostridium

10%Campylobacter

Salmonellosis

Cryptosporidiosis

6%E.coli (STEC)

Other *

AL 2011 Reported Diseases

Total = 2,260

Individual norovirus

Shigellosis

Campylobacteriosis

12%Giardiasis

SalmonellaOutbreak Timeline

Example

SMT WThFS

PatientEats

Contaminated

FoodBecomesIllVisits

Doctor

Sample

Incubation timeDelay seeking

Source: CDC

Collected)

Salmonella

Health

Serotyping

Confirmed

Outbreak

Specimen delivered

Uploaded

When two or more persons (from different

AL Foodborne Outbreak

Exceptions: botulism and chemical poisoning

Make Epidemiologic Associations

Person, place, time

Systematically organize key information

Develop initial hypothesis

Foodborne Illness: Changing

Epidemiology

Environment

Develop Initial Case Definition:

Counting Apples and Oranges

Objective criteria

Links person to place and time

Outbreak-associated vs.normal background

Value of routine surveillance data

Primary vs.secondary cases

Revise Case Definitions

Precise definitions reduce

Estimated 41% of enteric infections in U.S.

Incomplete case history can haunt you;

Incorrectly classifying individuals can bias

Make it harder to detect true associations.

Person: AL Outbreak Examples

Place: Common Exposure Location