PRINCIPLES OF EPIDEMIOLOGY " EPIDEMIOLOGY is concerned with the patterns of diseases occurrence in human populations and of factors that

influence these patterns." AIMS OF EPIDEMIOLOGY i. ii. iii. iv. To describe the distribution and magnitude of health and diseases problems in human population. To identify risk factors in the pathogenesis of diseases To provide the data essential to the planning, implementation, control and evaluation of services for the prevention, control and treatment of diseases. The ultimate aim of EPIDEMIOLOGY is to lead to effective action to eliminate or reduce the health problem.

IMPORTANT DEFINITIONS: 1. INFECTION - It is the entry and development of an infectious agent in the body. 2. INFESTATION - It is the presence of a parasite either on the surface or in the tissue of the body. E.g. Round worm infestation 3. ENDEMIC - It is a disease restricted to a particular area in a relatively low level throughout the area 4. ISOLATION - The separation of a person with infectious diseases from contact with other human beings, for the period of communicability. 5. VECTORS - They are the insects like mosquito, flies etc. which transmit diseases. 6. FORMITES - They are articles like towel, pens, pencils or even books which can absorb, retain and transfer an infection. 7. COMMUNICABLE DISEASE - Any disease that can be transferred from one person to another person. 8. NON-COMMUNICABLE DISEASES - This term is applied to such diseases as cancer, cardiovascular disease and diabetes which are not communicated from person to person. 9. TOXIN - It is a harmful substance produced in the body by an infecting micro-organisms. 10. NOSOCOMIAL INFECTION {HOSPITAL ACQUIRED INFECTION} - These are infections developing in hospitalized patients which were not present at the time of their admission. 11. MORTALITY - Mortality is death. the frequency of death and the number of peoples who die is a measure of health of a community. 12. MORBIDITY - Morbidity has been defined as sickness, illness, disability etc.

IMMUNITY Immunity is the body's ability to resistance against an infecting microorganism. Immunity is capable of destroying and eliminating infectious microorganisms. ANTIGEN - Antigen is a substance that stimulates the formation of an antibody. Antigen is a foreign protein that creates a disease in the body. ANTIBODY - Special protein substance that protects the body against infection. The antibody recognizes the diseases producing organisms and destroys it. TYPES OF IMMUNITY Immunity can be classified into a) Artificial Immunity b) Natural Immunity Artificial Immunity - it is produced by the administration of vaccines. Artificial immunity is classified into i. ii. ACTIVE IMMUNITY PASSIVE IMMUNITY

ACTIVE IMMUNITY - It involves the stimulation of the body to produce its own antibodies. the stimulation of antibody production is achieved by the administration of vaccines, toxiods etc. Active immunity takes sometime to develop, but it is of long duration. PASSIVE IMMUNITY - The body does not produce its own antibodies. but depends upon readymade antibodies. Passive Immunity develops rapidly, but it is of short duration.

Natural Immunity - This type of immunity is inherited from birth itself. this type of immunity provides natural resistance against diseases.

IMMUNISATION - It is defined as production of immunity by means of immunological agents. IMMUNISATION is classified asA. Passive Immunisation - which makes use of Antisera and Gamaglobulin B. Active Immunisation - which makes use of vaccines and toxiods.

IMMUNOLOGICAL PRODUCTS I. II. III. VACCINES ANTISERA IMMUNOGLOBULINS

VACCINES- A special preparation of antigenic material that can be used to stimulate the development of antibodies and thus active immunity against a disease. Vaccines are classified as: 1. LIVE VACCINE - Live Vaccine are prepared from live attenuated organisms. e.g. BCG, ORAL POLIO etc. except polio vaccine other are administrated in single dose. 2. KILLED VACCINE - They contain organisms which are killed by heat or chemicals. e.g. Cholera, typhoid etc. 3. MIXED VACCINE - A mixture of two or more vaccine. E.g. DPT and MMR {Triple vaccine} 4. TOXIOD - They are obtained by detoxicating the exotoxin produced by microorganisms. e.g. Tetnus Toxiods.

ANTISERA {ANTITOXIN}- The term antiserum is applied to material prepared in animals. e.g. Horses. they are used for passive immunisation against disease like tetnus, diphtheria etc. COLD CHAIN It is a system of transport and storage of vaccine at the proper temperature. In order to be effective. if exposed to heat they will lose their potency. Once potency is lost, the protective effect is also lost. So vaccine must be stored and transported at low temperature. All vaccines can be stored for few month at 2 to 8 degree c. DPT. tetnus toxiod, should not be frozen. THE COLD CHAIN EQUIPMENT a) At the State & Regional Stores - They are located at regional level, meant to store upto 3 months and serve 4-5 month. b) At the district stores - Deep freezers, refrigerators, cold boxes and vaccine carrier are available. c) At the primary health centre - Refrigerators - ice lined refrigerator, cold boxes and vaccine carrier are available. d) At the sub-centre - Cold Boxes, vaccine carrier, thermocole boxes are available. e) Storage of all Vaccines - Polio vaccine is the most sensitive to heat. it must be stored at the freezer compartment of refrigerator. Polio, measles and BCG vaccines which must be stored in the cold part of refrigerator but never allowed to freeze are Typhoid, DPT and tetnus toxoids.

EXPANDED PROGRAMME OF IMMUNIZATION It was launched by W.H.O. in 1974. it is a global Immunization programme. Its aim was to protect all the children of the world against the Six preventable diseases. UNIVERSAL IMMUNIZATION PROGRAMME It is a national immunization Programme in India. It was launched on 19th Nov, 1985. It was dedicated in memory of Smt. Indira Gandhi. Its aim was to provide immunization coverage of eligible population by 1990. IMMUNIZATION SCHEDULE FOR PREGNANT LADY i. ii. Early in Pregnancy - T.T - I After one month - T.T. - II

IMMUNIZATION SCHEDULE FOR CHILDREN AGE At Birth VACCINE B.C.G HEPT-B-O + O.P.V D.P.T - I HEPT-B-I O.P.V D.P.T - II HEPT. B - II O.P.V D.P.T - III HEPT-B- III O.P.V Measles - I Vit. A - I D.P.T Booster Dose Measles - II Vit. A - II D. P. T {2nd Booster Dose} T.T T.T DOSE 0.01 ML ROUTE g/d on left arm I/m Orally I/m I/m Orally I/m I/m Orally I/m

At 6 week or 1/2 month

0.5 ML

At 10 Week 2 1/2 month At 14 week or 3 1/2 month At 9 month 18 month 1 1/2 yrs

0.5ML

0.5 ML

0.5 ml 05. ml

S/C tissue I/m

At 5 yrs At 10 yrs At 15 yrs

0.5 ml 0.5 ml 0.5 ml

I/m I/m I/m