Epidemic , Pandemic and Endemic

Girish Patel, Nabila okanga ,keola MD 1 Epidemiology and biostatics Dr. Kumar Sukhraj

Epidemic Epidemics are defined as the occurrence of cases in excess of what is normally expected in a community or region.

HOW TO IDENTIFY
The number of cases needed to define an epidemic varies according to the agent, the size, type and susceptibility of population exposed, and the time and place of occurrence. The identification of an epidemic also depends on the usual frequency of the disease in the area among the specified population during the same season of the year.

CAUSES
Increased virulence Introduction into a novel setting Changes in host susceptibility to the infectious agent

TYPES
POINT SOURCE OUTBREAK affected individuals had an exposure to a common agent. affected individuals develop the disease over a single exposure and incubation course EXAMPLE- cholera

Propagated outbreak The disease spreads person-to-person. Affected individuals may become independent reservoirs leading to further exposures
Example--SARS was first recognized as a global threat in March 2003. It spread rapidly to 26 countries, affecting adult men and women, with a fifth of all cases occurring among health-care workers

Endemic
An infection is said to be endemic in a population when that infection is maintained in the population without the need for external inputs. example, chickenpox is endemic (steady state) in the UK but malaria is not.

Hyperendemic and holoendemic

The term hyperendemic expresses that the disease is constantly present at high incidence and/or prevalence rate and affects all age groups equally. The term holoendemic expresses a high level of infection beginning early in life and affecting most of the child population, leading to a state of equilibrium such that the adult population shows evidence of the disease much less commonly than do the children (e.g. malaria)

Pandemic
Definition--'an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people. Pandemic should be infectious because A disease or condition is not a pandemic merely because it is widespread or kills many people. E.g. Cancer Some example of pandemic disease are typhus, cholera, Influenza, malaria, yellow fever, tuberculosis,

Phase of influenza pandemic alert

Phase 1: A virus in animals has caused no known infections in humans. Phase 2: An animal flu virus has caused infection in humans. Phase 3: Sporadic cases or small clusters of disease occur in humans. Human-to-human transmission, if any, is insufficient to cause community-level outbreaks. Phase 4: The risk for a pandemic is greatly increased but not certain.

Phase 5: Spread of disease between humans is occurring in more than one country of one WHO region. Phase 6: Community-level outbreaks are in at least one additional country in a different WHO region from phase 5. A global pandemic is under way.