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BBH 440-Epidemiology, Text Study Guide, Exam 1
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BBH 440-Epidemiology, Text Study Guide, Exam 1Text: Friis, R.H., & Seller, T.A. Epidemiology for Public Health Practice, 4th Edition.
Note: The term "recognize" below means that the concept or topic might be used in a multiple choice
question. You should study to be able to understand the term or concept and know how it related to
Epidemiology.
Chapter 1: History and Scope of Epidemiology
Know...
....the meaning of or the significance of the specialized terms, phrases, and concepts in this chapter including,
but not limited to: epidemiology, epidemic, endemic, pandemic, EIS, morbidity, mortality, surveillance,
"natural experiments" the "broad Street Pump" "Removing the Handle of the Broad Street Pump"
Mortality: refers to death
Morbidity: refers to illness
Pandemic: refers to an epidemic on worldwide scale
Endemic: characterizes a disease that is habitually present in a particular geographical region.
Surveillance: denotes the systematic collection of data pertaining to the occurrence of specific
diseases
Natural experiments: naturally occurring situations, as seen in the broad street pump.
Broad street pump: had its water supply pumped from 2 different companies that were supplying
different levels of contamination.
Removing the handle of the broad street pump: Snows theory had the handle of the broad street pump
removed to prevent further use and spread of cholera.
...the definition of epidemiology;
Concerned with the distribution and determinates of health and diseases, morbidity, injuries,
disability and mortality in a population
...aims of epidemiology (recognize); (pg 12)
o To describe health status of populations…
o To explain the etiology of the disease….
o To predict the occurrence…
o To control the distribution…
...Koch postulates (recognize);
1. The microorganism must be observed in every case of the disease.
2. It must be isolated and grown in pure culture.
3. The pure culture must, when inoculated into a susceptible animal, reproduce the
disease.
4. The microorganism must be observed in, and recovered from the experimentally
diseased animal.
,BBH 440-Epidemiology, Text Study Guide, Exam 1
...purposes of quantification in epidemiology;
It is the translation of qualitative impression into numbers to objective subjective impressions.
...purposes and uses of pie charts, bar graphs, etc. in epidemiology;
These graphs are used to describe characteristics of data, such as subgroup differences and time
trends.
...importance and major contributions (recognize) to epidemiology of the following persons: Hippocrates,
Graunt; Snow; Semmelweis, Farr, Koch, Doll & Peto
Hippocrates: his thinking represented a movement away from supernatural explanations for disease,
causation to a rational account of the origin of humankind’s illnesses.
o Disease may be might be associated with the physical environment.
Graunt: published the “natural and political observations mentioned in a following index and made
upon the bills of mortality”.
o Recorded descriptive characteristics of birth and death data, including seasonal variations,
infant mortality, excess in male over female differences in mortality.
o His work made fundamental contribution by discovering regularities in medical and social
phenomena.
o First to employ quantitative methods in describing population vital stats by organizing data
into tables…
o Columbus of statistics
Snow: investigated a cholera epidemic that occurred during the 19th century in Broad Street, London.
o His study linked the cholera epidemic to contaminated water supplies by using a spot map of
cases and tabulation of fatal attacks and deaths.
o His methods utilized logical observations, a natural experiment and a quantitative approach.
Semmelweis: observed that women in maternity wards were dying at high rates of puerperal fever.
o He realized once medical education changed women in the teaching wards with medical
students were dying at higher rates than women giving birth in the teach wards for mid wives.
▪ Came to the conclusions that doctors and medical students were contaminating their
hands during autopsies they implemented hand washing with a chlorinated solution.
Farr: provided the foundation for the International classification of disease
o He used data such as census reports to study occupational mortality in population density
Koch: confirmed that a human disease was caused by specific living organism.
Doll & Peto: lung cancer and the association with smoking.
Example True or False questions for Chapter 1:
Answer the question true if mainly true, false if mainly false.
1. John Graunt is known as the Columbus of biostatistics. True?
2. Socrates popularized the notion that the environment is associated with human disease. false
3. In a study of total trihalomethanes (TTHM), Swan, Waller, and colleagues did not show any
association between TTHMs in tap water and rate of spontaneous abortions.
4. Molecular epidemiology applies the techniques of molecular biology to epidemiologic studies. true
, BBH 440-Epidemiology, Text Study Guide, Exam 1
5. Most of the time, epidemiologic researchers confront a problem that has a clear etiologic basis. false
6. The study of diseases linked to harmful physical energy, such as ionizing radiation, would be outside
the scope of epidemiology. false
7. The Framingham Heart Study, begun in 1949, pioneered research into coronary heart disease risk
factors. False started in 1948
8. Koch published Die Aetiologie der Tuberkulose in 1882, a breakthrough that led to improved
classification of disease. true
9. One of William Farr’s contributions to public health and epidemiology included the development of a
more sophisticated system for codifying medical conditions. true
10. In current thinking, the term epidemic is used only to describe outbreaks of infectious disease. False?
Example Multiple Choice Questions for Chapter 1
1. Which of the following activities characterizes a clinical approach (as opposed to an
epidemiologic approach)?
A. Description of specific signs and symptoms
B. Description of seasonal trends in disease occurrence
C. Examination of disease occurrence among population groups
D. Demonstration of geographic variations in disease frequency
2. John Snow, in Snow on Cholera:
A. was the father of modern biostatistics.
B. established postulates for transmission of infectious disease.
C. was an early epidemiologist who used natural experiments.
D. argued that the environment was associated with diseases such as malaria.
3. Which of the following activities characterizes an epidemiologic approach (as opposed to a
clinical approach)?
A. Description of a single individual’s symptoms
B. Surveillance of a population
C. Treatment of a patient with diagnosed illness
D. A and C
4. Cyclic variations in the occurrence of pneumonia and influenza mortality may reflect:
A. seasonal variations in cases of influenza.
B. the fact that influenza is a disappearing disorder.
C. long-term changes in mortality trends.
D. both A and B
5. Which of the following is not usually an aim of epidemiology?
A. To describe the health status of the population
B. To fund new public health programs
C. To explain the etiology of disease
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