Koch's postulates are the following:

1. The microorganism must be found in abundance in all organisms suffering from

the disease, but should not be found in healthy organisms.
2. The microorganism must be isolated from a diseased organism and grown in
pure culture.
3. The cultured microorganism should cause disease when introduced into a
healthy organism.
4. The microorganism must be reisolated from the inoculated, diseased
experimental host and identified as being identical to the original specific
causative agent.
In 1890 the German physician and bacteriologist Robert Koch set out
his celebrated criteria for judging whether a given bacteria is the
cause of a given disease. Koch's criteria brought some much-needed
scientific clarity to what was then a very confused field.
Koch's postulates are as follows:

 The bacteria must be present in every case of the disease.

 The bacteria must be isolated from the host with the disease and
grown in pure culture.

 The specific disease must be reproduced when a pure culture of

the bacteria is inoculated into a healthy susceptible host.

 The bacteria must be recoverable from the experimentally

infected host.

However, Koch's postulates have their limitations and so may not

always be the last word. They may not hold if:

 The particular bacteria (such as the one that causes leprosy)

cannot be "grown in pure culture" in the laboratory.
  There is no animal model of infection with that particular bacteria.

A harmless bacteria may cause disease if:

 It has acquired extra virulence factors making it pathogenic.

 It gains access to deep tissues via trauma, surgery, an IV line,

etc.

 It infects an immunocompromised patient.

 Not all people infected by a bacteria may develop disease-

subclinical infection is usually more common than clinically
obvious infection.

Despite such limitations, Koch's postulates are still a useful

benchmark in judging whether there is a cause-and-effect relationship
between a bacteria (or any other type of microorganism) and a clinical
disease.

Question Answer
What is CDC? Centers for Disease Control
and Prevention
What is OIE? World Organisation for Animal
Health (known by its French
acronym Office International
des Epizooties – OIE)
What is USDA- APHIS? United States Department of

what is USDA –FSIS?
what is AVMA?
Epidemiology is?
what is a population?
What is EBM (evidence based
medicine)?
EBM uses POPULATION DATA
to better understand these 4
areas
What is
endemic(human)/enzootic(animal)
? disease is endemic when it
What is Epidemic (epizootic)?
Agriculture- Animal and Plant
Health Inspection Service
United States Department of
Agriculture - Food Safety and
Inspection Service
American Veterinary Medical
Association
the greek of the word means...
"the study of what is upon the
population". SO, it is the Study
of the occurrence and
distribution of disease in
populations (animal or
human) (Emphasis on establishing
the causal factors that influence
disease occurrence)
the totality of individuals that
share common attributes (sex,
breed, ethnicity, location)
"the conscientious, explicit and
judicious use of current best
evidence in making decisions
about the care of the individual
patient.”
dx, prevention, tx, prognosis
Usual (constant) frequency of
disease in a population. A
occurs with predictable
regularity in a population. (Note:
Endemics can become epidemics if
host-agent-environmental factors
change)
Often synonymous with the
term outbreak and typically

What is Pandemic?
The WHO (world health
organization) defines their "phase
6- pandemic phase" as
"sporatic" disease occurance is
defined as...
used for infectious diseases.
An epidemic disease is a
disease that is rapidly spread
and many individuals acquire
disease over a short period.
A widespread
epidemic/epizootic……involvin
g more than one country.
There is a more specific def.
made by the WHO(World Health
Organisation), which requires...:
There must be a disease new
to a population – or at least a
disease that had not surfaced
for a long time. This disease
must be caused by disease-
causing agents that infect
humans, causing serious
illness. AND, The agents must
spread easily and sustainably
among humans causing high
morbidity and high mortality
the pandemic phase, is
characterized by community
level outbreaks in at least one
other country in a different
WHO region in addition to the
criteria defined in Phase 5.
Designation of this phase will
indicate that a global pandemic
is under way.
A disease that is NOT NEW &
occurs infrequently (without
regularity) in a population.
Cases occur in small numbers,
illness is not apparently
connected with similar illnesses
in any other animals/persons,

explain epidemic vs sporatic
what is Public health
surveillance?
what is passive surveillance?
what is Active surveillance?
what is a host?
and it is not rapidly spread
Whilst an epidemic can be 1
case of a new disease, it is
rapidly spread between
animals /humans... BUT!!! A
sporadic case refers to a
person/animal whose illness is
not rapidly spread and not
apparently connected with
similar illnesses in any other
animals or humans
Public health surveillance is the
ongoing, systematic collection,
analysis, interpretation, and
dissemination of data regarding
a health-related event for use
in public health action to
reduce morbidity and mortality
and to improve health
(CDC,2001).
System in which Vet agencies
make no active efforts to
collect disease info (But Problem:
Some info on disease frequency
but not accurate.)
Uses structured disease
surveys to collect high quality
disease info quickly. A survey:
Trained veterinary staff
examine only a sample of the
population. (more costly but more
accurate)
An individual (animal or
human) that harbours an
Infectious agent or is exposed
to a potential causal agent of
disease which is usually
infectious. Typically used in

What is a demographic?
what is a case?
what are Causal factors or
determinants?
what is infection?
what is disease DEFINED as?
Question
what are the three corners of the
epidemeologic triangle? What is
this triangle used for?
reference to infectious
diseases although in general
hosts are also susceptible to
noninfectious and chronic
diseases.
Personal characteristics of an
individual or group (age, sex,
breed, occupation)
Individuals with a particular
disease that meet selected
criteria stated by the case
definition
A factor that directly influences
the occurrence of
disease. Synonymous with
risk factor or exposure factor
Defined as the encounter of a
potentially pathogenic agent
with a susceptible human
/animal host and the host
shows an immunologic
response to infection.
a clinically apparent infection
— infection accompanied by
overt illness.
Answer
Host-Agent-Environment. It is
used as A model to explain
why diseases occur in a
population.
Temporal (in time) disease
occurance reporting uses what
kinda terminology (list...)
how would you describe endemic
in terms of temporal patterns?
how would you describe
epidemic in terms of temporal
patterns? how do you depict the
occurrence of the dz?
how would you describe
pandemic in terms of temporal
patterns?
The shape of an epidemic curve
tells us what two major things?
what are the 3 basic curves of
disease occurrence on the
epidemic curve?
what is a "point source" epidemic
curve? what does the curve look
like on the graph?
Endemic (enzootic), Epidemic
(epizootic), Pandemic
(panzootic), Sporadic
dz occurs at expected
frequency, present in
population or region at all
times, and Usually low and
predictable level
disease occurs at greater than
expected frequency.
Occurrence depicted
graphically as "Epidemic
curves"
sporatic
These are histograms
depicting the no. of new cases
(Y) axis over time (X) axis.
Using this info, we can get
info on probable time of
exposure based on the
incubation period, and also
info on if the outbreak was
due to a common or point
source
(1) Point epidemic (point
source) (2) Continuous
common source epidemic (3)
Propagating epidemic
animals or persons are
subjected to the same BRIEF
exposure over a limited,
defined time period, usually
within 1 incubation period.
The graph looks like Curve
commonly rises rapidly and

what is a
"continuous(common) epidemic"
epidemic curve? what does the
curve look like on the graph?
what is a "propagating epidemic"
epidemic curve? What does the
curve look like on the graph?
what is the frequency of an
endemic like?
what is the frequency of an
epidemic like?
what is the frequency of "sporatic
disease" occurance like? What is
distinct about them?
look at slide 24 for sporatic vs
endemic vs epidemic
what does a time series analysis
contains a definite peak at the
top, followed by a decline
once the point source is
removed, no new cases
occur (see slide 14)
Exposure to the source is
prolonged over an extended
period of time and may occur
over > one incubation period.
On the graph, The down slope
of the curve may be very
sharp if the common source is
removed or gradual if the
outbreak is allowed to exhaust
itself (see slide 16)
Occurs when disease is
introduced through a single
(primary) source of infection in
1 animal and then transmitted
to other animals. The graph
has multiple peaks and
regressions (see slide 20)
disease occurs at expected
frequency
disease occurs at greater than
expected frequency
only a small number of cases
are observed during a short
period of time, Disease occurs
rarely and without regularity,
and there are no secondary
cases
epi and sporatic look similar,
except sporatic is much fewer
cases
Uses the information on
do?
what are the three trends of time-
series analysis?
what is a secular trend?
what is a cyclical trend like?
what are some factors which
would make a cyclical trend a
seasonal trend?
Disease occurrence can be
affected by host factors such as...
What is Incidence?
patterns of disease
occurrence obtained from
temporal occurrence
data...the temporal
occurrence data will identify
periods of high/low risk
(trends) of disease
occurrence--> allows casual
associations to be explored
short-term, cyclical (including
seasonal), secular trends
a long term trend, where the
Data reflects an Overall inc or
dec in incidence occurring
gradually over long time
periods
Rise and fall of disease over
greater than 1 year
Associated with regular,
periodic fluctuations in level of
disease occurrence
things like host density (all
migrating together or sthing),
Management practices,
Vector borne diseases (fly
season), Infectious agent
survival due to environmental
factors
age, sex, breed
a measure of the frequency
with which new cases occur
over a specified time
period (other explanations
given are:)The proportion of a
population, initially free of the
outcome of interest, that

What is prevalence?
what is attack rate?
What is the math problem
for incidence?
how are units of population
expressed?
What is the math problem
for prevalence?
how is incidence expressed,
versus prevalence?
develops the disease over a
given period of time.
Incidence refers to NEW
cases of disease
The number of cases that
are present in a given
population (other
explanations given are:)
Proportion of the population at
a given time that have the
factor of interest
Measure of the proportion of
the population that develops
disease at the start of an
outbreak among the total
exposed
I(per 1,000)= the number
of new cases in a population
during a particular period of
time, DIVIDED BY the number
of individuals at risk of
developing the
disease during that period of
time. All of this is multiplied by
1000.
Unit of population expressed
as whole numbers and in the
smallest multiples of 10
# of individuals having a
disease at a particular point in
time DIVIDED BY # of
individuals in the population at
risk at that point in time
incidence is usually expressed
numerically in reference to
population at risk (X out of a
1000 or whatever mult of 10).

what is point prevalence?
what does incidence account for
that prevalence doesnt?
What is period prevalence?
what is the math equation which
relates incidence and
prevalence?
check out prevalence vs
incidence example starting on
slide 53
what is a cluster analysis?
what is data modelling used for?
what is a case definition?
Prevalence is usually
expressed as a proportion
between 0 and 1, OR a %, OR
As a unit of population at risk
Number of cases in a
population, at a particular
point in time.
prevalence, (unlike incidence),
does not take into account the
duration of disease. It is a
snapshot at this point in time.
How many people have had
the disease during a certain
time period, for example over
1 calendar year. It is a
combination of point
prevalence and incidence
Prevalence=Incidence x
Duration of disease
helpful
Geographical information
systems used to measure
disease occurrence in time
and space... This allows us to
ID geographical clustering of
disease and define as
endemic, epidemic, sporadic,
pandemic based on
timelocation
used to test hypotheses and
plan health policies
set of uniformly applied
criteria for a particular disease
 Causal relationships
Question
What is Infection?
what is Pathogenic?
what is Virulence?
Resistance to disease in populations
is called...?
The stronger the association between
a presumed causal factor and disease
or outcome, the more likely a cause
and effect relationship exists.This is
which criteria for establishing a
cause?
non-statistical strength of association
means?
Positive statistical association may
indicate...?
A negative statistical association may
indicate...?
example/explanation of a causal
factor being Necessary and
sufficient?
example/explanation of a causal
factor being Necessary but not
sufficient?
example/explanation of a causal
factor being Sufficient but not
necessary?
Answer
ability of the agent to establish itself in
a host
ability of agent to produce disease in
host
Measure of severity of disease due to
agent
herd immunity
Strength of association
it happened by chance, no real cause
or relation
causality
a protective factor
Certain dose of virus required for
infection
Occurrence of disease requires two
or more factors are present
Passive smoking can cause feline
lymphoma, but other causes of feline
lymphoma exist
example/explanation of a causal
factor being Neither sufficient nor
necessary but can contribute to
existing disease?
what is Temporal Precedence?
Dose-response relationship...what
must you remember about this criteria
of causal factors?
"Reversible association" criteria of
causal factors means/asks...
what is the strongest type of
epidemiologic study providing
EVIDENCE (NOT PROOF) that an
association might be causal? What
are the less strong types?
Relative Risk ratios are used in what
studies? Odds Ratios are used in
what studies? what do they both
measure?
High fat diet and Cardiovascular
disease
The evidence provided demonstrates
that your cause happened before
your disease occurrence.
disease may not develop until
exposed to a certain level [ex:
exposure/smoke]
Does the removal of a factor results in
a decreased or increased frequency
of disease? (ex: Cessation of smoking
leads to reduction of inflammatory &
haemostatic markers for cardiovascular
disease)
A Randomized clinical trial is Best
evidence for causality! Other trials
which are not randomized, so are less
strong are: cohort and case control,
cross sectional, cases series, case
report
RR is used in cohort studies. OR is
used in case-control studies. They
measure the STRENGTH of the
association between the
causal/exposure factor and disease
which is a Major criteria for judging
causal inferences