Epidemiological Concepts For Health Care Administration - IDRev2

<HCA 302>: <Healthcare Finance> : <Module 1>
Module Details:
Course Name Healthcare Finance
Module Name Foundations of Epidemiology
Version Responsibility Date

V1 Vidya.M 28.06.2019
V2 Vidya.M 03.07.2019
V3
Note to the Reviewer/SME:

Text that appears in grey boxes or highlighted in grey provides an explanation for graphic and review teams and
not part of the onscreen Text.
LMS Content
Module Overview
Welcome to Module 1!
In this module, you will review the basics of epidemiology and begin to build an epidemiology
vocabulary. To truly understand any subject, you must be able to speak the language used. Therefore,
building a strong vocabulary is paramount to success in this course. You will explore the differences
between descriptive and analytic epidemiology, learn the differences between an epidemic, endemic,
and pandemic, as well as levels of prevention. The role of epidemiology in public health practice is
explained. As well as, the concepts of disease transmission and how to use an epidemiology triangle.
Module Objectives
Upon successful completion of this module, students will be able to:
1. Define epidemiology, descriptive and analytic epidemiology, epidemic, endemic, and

pandemic, and the three levels of prevention
2. Explain the role of epidemiology in public health practice
3. Describe disease transmission concepts, the epidemiology triangle, and common source,
propagated, and mixed epidemics
4. Describe the contributions of key individuals to the field of epidemiology
5. Recognize various study designs used in epidemiology
6. List important historic events in the field of epidemiology
OST
Screen Number: 12
Screen Title: Topic 1: The Basics – Building your Epidemiology Vocabulary
To understand epidemiology, you must build

your vocabulary! The first activity in this area
will assist you in doing just that.
In order to be successful, in any endeavor,
you must build your vocabulary.
Epidemiology is no different. Below you will
find a table of terms that you should be able
to express in your own words (not verbatim
from a book or dictionary). This table is just a
beginning and you should continue to add
new terms and their meanings in your own
language. The first term, Epidemiology has
been included as an example. Feel free to
alter the understanding to suit your knowledge. Use this chart throughout the course and you will have a very
good understanding of this scientific field.
TERM MY UNDERSTANDING of the TERM Commented [FEV1]: This should have been provided as a
PDF download as it is not editable on screen, neither does it
Epidemiology A field of science that studies health problems within populations have a solution.
Analytic Epidemiology
Descriptive Epidemiology
Efficacy
Effectiveness
epidemic
pandemic
Endemic
Common-source
Propagated
Vehicle-borne transmission
Mixed epidemic
Case
Case definition
Primary case
Secondary case
Suspect case
Index case
pathogen
Epidemiology triangle
Fomite
Vector
Reservoir
Zoonosis
Vehicle
Carrier
Active carrier
Healthy or passive carriers
Convalescent carrier
Incubatory carrier
Intermittent carrier
Modes of Transmission
Direct transmission
Indirect transmission
Airborne transmission
Vector-borne transmission
Vehicle-borne transmission
Mechanical transmission
Biological transmission
Chain of infection
Portal of exit
Portal of entry
Primary prevention
Active primary prevention
Passive primary prevention
Secondary prevention
Tertiary prevention
Rehabilitation
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Sample Template:
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Screen Number: 23
Screen Title: Check your Understanding Commented [FEV2]: Please work on all the check your
understanding questions based on the changes I did here.
Characterization of the distribution of health-related states or events defines:
Select the correct option.
a. Descriptive epidemiology
b. Analytic epidemiology
c. Epidemiology
d. Activities in epidemiology
Correct option feedback:

That’s correct. Characterization of the distribution of health-related states or events defines
descriptive epidemiology.
Feedback for 1st incorrect try

Option B:
That’s not correct. Please try again.
Analytic epidemiology involves finding and quantifying associations, testing hypotheses, and
identifying causes of health-related states or events.
Option C:
Epidemiology is the study of the distribution and determinants of health-related states or
events in human populations and the application of this study to the prevention and control
of health problems.
Option D:
Activities in epidemiology refer to a range of activities in which an epidemiologist might be
involved, which require identifying, describing, monitoring and evaluating various factors.
Feedback for 2nd incorrect try

That’s not correct. Characterization of the distribution of health-related states or events
defines descriptive epidemiology.
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Sample Template:
OST
Screen Number: 34
Screen Title: Check your Understanding Commented [FEV3]: I had asked the ID to update these
questions based on the modifications I did for the previous
slide.
When a health event occurs in excess of normal within a community or region, what has The hyphens haven’t been removed. The explanations are
occurred? written in award/incorrect English.
a. Epidemic – this is correct

b. Endemic -
c. Pandemic -
d. Propagated epidemic
Correct Option Feedback
That’s correct. When a health event occurs in excess of normal within a community or region,
Epidemic has occurred.
Option B:
Endemic is a disease that is said to endemic when it continually prevails in a region

Option C:
Pandemic is an epidemic affecting or attacking the population of an extensive region, country or
continent
Option D:
Propagated Epidemic: These are termed as infections transmitted from one infected person
to another
That’s not correct. When a health event occurs in excess of normal within a community or region,
Epidemic has occurred.
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Sample Template:
OST
Screen Number: 45
Screen Title: Topic 2: The Epidemiology Triangle

The epidemiology triangle is a concept that helps us understand the interrelatedness of four factors
that contribute to disease outbreaks. The four factors involved are: 1) the host, 2) the agent, 3) the
environment, and 4) time. Control over any one of these will assist in stopping the outbreak.
Image ID:
Alt Text: There are four factors which contribute to the disease outbreak. Four factors are Host, Agent,
Environment, and Vector. Host is interlinked with Vector, Agent, and Environment. Environment is
connected to agent, vector, and host. Agent is connected to vector, environment, and host. Vector is
connected to Agent, Environment, and Host.
Sample Template:
OST
Screen Number: 56
Screen Title: Topic 2: The Epidemiology Triangle

In this activity you will use the CDC website to participate in an interactive app: Solve the Outbreak.
Select each step to learn how to access the app.

1. Go to https://www.cdc.gov/mobile/applications/sto/sto-web.html
2. Select Solve the Outbreak
3. Select level 1 (12 outbreaks)
4. From level 1 select the outbreak titled: Breathless in the Midwest, and have fun!
5. Across the bottom of each slide you will see the icons to access clues, cases, tips, data,
definition, and health tips.
Be sure to review these as you move through each slide. They contain information that will help you
answer the questions. IF you solve the level 1 outbreaks feel free to move to level 2.
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Sample Template:
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Screen Number: 67
Screen Title: Check your Understanding Commented [FEV4]: The correct option is mentioned
along with the question segment. This should have been
removed. Only retaining the yellow highlight would have
What disease was introduced to Native Americans when settlers arrived in America? been enough.
a. Small pox – This is correct!
b. Chicken pox
c. Polio
d. Yellow Fever
That’s correct. Small pox was introduced to Native Americans when settlers arrived in America. It
appeared around 10,000 BC, at the time of the 1st agricultural settlements in north eastern Africa
Option B:
Chicken pox was introduced by Giovanni Filippo during 16th century
Option C:
Polio was the first outbreak in epidemic form during the year 1894 at US with 132 cases
Option D:
Yellow fever occurs and transmitted due to the mosquitoes. This was proved by Walter Reed
on August 27th 1900.
That’s not correct. Small pox was introduced to Native Americans when settlers arrived in America.
It appeared around 10,000 BC, at the time of the 1st agricultural settlements in north eastern Africa
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Screen Number: 78
Screen Title: Check your Understanding
Agents of infectious disease may be:
Select all the options that apply.
a. Bacteria – This is correct! -

b. Virus – This is correct! -
b.
c. Parasites – This is correct!
c.
d. Fungi – This is correct!
d. -
e. Molds – this is correct! -

That’s correct. All five options are right.

Bacteria are the agents that cause disease fall into five groups: viruses, bacteria, fungi, protozoa, and
helminths (worms).
Virus - viruses, bacteria, and fungi are the subject of microbiology
Parasites are the Protozoa and worms are usually grouped together as parasites and are the subject
of parasitology
Fungi - viruses, bacteria, and fungi are the subject of microbiology
Molds –some molds are human pathogens, they are a type of fungi
Option B:
Option C:
Option D:
That’s not correct. All five options are right.
Bacteria are the agents that cause disease fall into five groups: viruses, bacteria, fungi, protozoa, and
helminths (worms).
Virus - viruses, bacteria, and fungi are the subject of microbiology
Parasites are the Protozoa and worms are usually grouped together as parasites and are the subject
of parasitology
Fungi - viruses, bacteria, and fungi are the subject of microbiology
Molds –some molds are human pathogens, they are a type of fungi
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Sample Template:
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Screen Number: 89
Screen Title: Topic 3: The Chain of Infection Commented [FEV5]: This activity must be removed or we
have to get back to the SME. The link wasn’t working and
Activity information taken from: the issue wasn’t identified by the storyboarder.
https://www.cdc.gov/ophss/csels/dsepd/ss1978/lesson1/section10.html
The chain of infection is an important concept in all fields of medicine. The following exercise is provided
by the CDC. First you will read about Dengue, an infectious disease. Then you will outline the chain of
infection by identifying the reservoir(s), portal(s) of exit, mode(s) of transmission, portal(s) of entry, and
factors in host susceptibility.
1. Reservoirs:
2. Portals of exit:
3. Modes of transmission:
4. Portals of entry:
5. Factors in host susceptibility:

ANSWERS:
1. Reservoirs: humans and possibly monkeys

2. Portals of exit: skin (via mosquito bite)
3. Modes of transmission: indirect transmission to humans by mosquito vector
4. Portals of entry: through skin to blood (via mosquito bite)
5. Factors in host susceptibility: except for survivors of dengue infection who are immune to
subsequent infection from the same serotype, susceptibility is universally Commented [FEV6]: This link is no longer accessible. This
must be raised as an issue. The SME has to provide an
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Alt Text:
Also, for all activities that are taken from external links, we
Sample Template: must place a small introductory content on the module
page and direct the student to the relevant webpage to take
up the complete activity. This must be done to avoid any
copyright conflicts.
Commented [M7R6]: Ok mam. Once SME gives me the
details, I can work on it
OST
Screen Number: 910
Screen Title: Fact Sheet on Dengue
The following fact sheets on Dengue would give you a better idea about the causes and
occurrences of dengue, treatment for dengue and transmission of dengue fever.
Select each tab to learn more about dengue
What is dengue?
Dengue is an acute infectious disease that comes in two forms: dengue and dengue hemorrhagic
fever. The principal symptoms of dengue are high fever, severe headache, backache, joint pains,
nausea and vomiting, eye pain, and rash. Generally, younger children have a milder illness than older
children and adults.
What is dengue hemorrhagic fever?

Dengue hemorrhagic fever is a more severe form of dengue. It is characterized by a fever that lasts
from 2 to 7 days, with general signs and symptoms that could occur with many other illnesses (e.g.,
nausea, vomiting, abdominal pain, and headache). This stage is followed by hemorrhagic
manifestations, tendency to bruise easily, or other types of skin hemorrhages, bleeding nose or gums,
and possibly internal bleeding. The smallest blood vessels (capillaries) become excessively permeable
(“leaky”), allowing the fluid component to escape from the blood vessels. This may lead to failure of
the circulatory system and shock, followed by death, if circulatory failure is not corrected. Although
the average case-fatality rate is about 5%, with good medical management, mortality can be less than
1%.
What causes dengue?
Dengue and dengue hemorrhagic fever are caused by any one of four closely related flaviviruses,
designated DEN-1, DEN–2, DEN-3, or DEN-4.
How is dengue diagnosed?
Diagnosis of dengue infection requires laboratory confirmation, either by isolating the virus from
serum within 5 days after onset of symptoms, or by detecting convalescent-phase specific antibodies
obtained at least 6 days after onset of symptoms.
What is the treatment for dengue or dengue hemorrhagic fever?
There is no specific medication for treatment of a dengue infection. Persons who think they have
dengue should use analgesics (pain relievers) with acetaminophen and avoid those containing aspirin.
They should also rest, drink plenty of fluids, and consult a physician. Persons with dengue hemorrhagic
fever can be effectively treated by fluid replacement therapy if an early clinical diagnosis is made, but
hospitalization is often required.
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Sample Template:
OST
Screen Number: 101
Screen Title: Fact Sheet on Dengue
The following fact sheets on Dengue would give you a better idea about the causes and
occurrences of dengue, treatment for dengue and transmission of dengue fever.
Select each tab to learn more about dengue.
What common is dengue and where is it found?
Dengue is endemic in many tropical countries in Asia and Latin America, most countries in Africa, and
much of the Caribbean, including Puerto Rico. Cases have occurred sporadically in Texas. Epidemics
occur periodically. Globally, an estimated 50 to 100 million cases of dengue and several hundred
thousand cases of dengue hemorrhagic fever occur each year, depending on epidemic activity. Between
100 and 200 suspected cases are introduced into the United States each year by travelers.
How is dengue transmitted?
Dengue is transmitted to people by the bite of an Aedes mosquito that is infected with a dengue virus.
The mosquito becomes infected with dengue virus when it bites a person who has dengue or DHF
(dengue hemorrhagic fever) and after about a week can transmit the virus while biting a healthy person.
Monkeys may serve as a reservoir in some parts of Asia and Africa. Dengue cannot be spread directly
from person to person.
Who has an increased risk of being exposed to dengue?
Susceptibility to dengue is universal. Residents of or visitors to tropical urban areas and other areas
where dengue is endemic are at highest risk of becoming infected. While a person who survives a bout
of dengue caused by one serotype develops lifelong immunity to that serotype, there is no cross-
protection against the three other serotypes.
What can be done to reduce the risk of acquiring dengue?
There is no vaccine for preventing dengue. The best preventive measure for residents living in areas
infested with Aedes aegypti is to eliminate the places where the mosquito lays her eggs, primarily
artificial containers that hold water. Pet and animal watering containers and vases with fresh flowers
should be emptied and scoured at least once a week. This will eliminate the mosquito eggs and larvae
and reduce the number of mosquitoes present in these areas. For travelers to areas with dengue, as
well as people living in areas with dengue, the risk of being bitten by mosquitoes indoors is reduced by
utilization of air conditioning or windows and doors that are screened. Proper application of mosquito
repellents containing 20% to 30% DEET (N, N-Diethyl-meta-toluamide) as the active ingredient on
exposed skin and clothing decreases the risk of being bitten by mosquitoes. The risk of dengue infection
for international travelers appears to be small, unless an epidemic is in progress.
Can epidemics of dengue hemorrhagic fever be prevented?
The emphasis for dengue prevention is on sustainable, community-based, integrated mosquito control,
with limited reliance on insecticides (chemical larvicides and adulticides). Preventing epidemic disease
requires a coordinated community effort to increase awareness about dengue/DHF (dengue
hemorrhagic fever), how to recognize it, and how to control the mosquito that transmits it. Residents
are responsible for keeping their yards and patios free of sites where mosquitoes can be produced.
Source: Centers for Disease Control and Prevention [Internet]. Dengue Fever. [Updated 2005 Aug 22].
Available from https://www.cdc.gov/ncidod/dvbid/dengue/index.htm
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1. When thinking of the chain of infection, food, water, and feces, are examples of a ______.
a. Reservoir – this is correct!
b. Mode of transmission –
c. Susceptible host –
d. Infectious agent –
That’s correct. Chain of infection, food, water and feces, are examples of a reservoir
Option B:
Mode of transmission includes direct and indirect methods of transmitting the infection
Option C:
Susceptible Host is a human or animal that has no immunity to the pathogen
Option D:
Infectious Agent is the germ or pathogen that causes disease

That’s not correct. Chain of infection, food, water and feces, are examples of a reservoir
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OST
Screen Number: 123

2. When thinking of the chain of infection, where does disease transmission begin?
a. At the Reservoir – this is correct!
b. Portal of exit –
c. Portal of entry –
d. Mode of transmission –.
That’s correct. Transmission begins when the pathogen leaves the reservoir
Option B:
Portal of exit is the portals of exit include the nose, mouth, blood, and bodily fluids. Once a
pathogen leaves a reservoir it must go through a portal of exit.
Option C:
Portal of entry is the portals of entry include mucous membranes and wounds. These are areas
where a pathogen enters a susceptible host
Option D:
Mode of Transmission - this is either direct or indirect. It is how the pathogen gets from one person
to another but it is not where transmission occurs
That’s not correct. Transmission begins when the pathogen leaves the reservoir
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Sample Template:
OST
Screen Number: 134
Screen Title: Break the chain Video
The corresponding video is from TNF Film, which was Published on July 16, 2012. After watching the video,
reflect on the questions below.
Select play to watch the video

1. What are the six links in the chain of infection?
2. What are three examples of Blood-borne infections?
3. What is an example of an Air-borne disease?
4. What are three examples of a droplet diseases?
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https://www.youtube.com/watch?v=Umtmc1GxOI4
OST
Screen Number: 145

Screen Title: Infectious Disease Forecasting … For the World I Dr. James Wilson I TEDX Reno Video
This video is taken from famous TEDX Talks that was Published during Jan 19, 2016. Watch the video
and try to answer the following questions

1. In the beginning of the 2oth century what caused fear among the people of the world?
2. What infectious diseases have taken us by surprise during the past 25 years?
3. What does the National Infectious Disease Forecast Centre (NIDFC) offer the public?
4. What is the greatest threat of our time?
5. What would you do with a disease forecast?
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Sample Template:
https://www.youtube.com/watch?v=oLeDTXnaGkw
OST
Screen Number: 156
Screen Title: Epidemic, Pandemic, Endemic? Video
This video is a talk given by Savannah Burdine that was Published on March 6, 2017. Students are
instructed to watch only through 2:45. Watch the video and answer the following questions

1. How is an epidemic defined, provide an example?
2. How is an endemic defined, provide an example?
3. How is a pandemic defined, provide an example?
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Sample Template:
https://www.youtube.com/watch?v=O12keHSXSfg
OST
Screen Number: 167
Screen Title: Additional Resource: Pandemic 2 – The Game Commented [FEV8]: When I placed my comment for
rewriting, the storyboarder should have looked into the
game and written a brief description instead of directing it
Watch the video, understand the tutorial, and then select new game to have more fun! back to the SME.
Commented [FEV9]: Please rewrite the scree content to
Select play to watch the video indicate that it is a game that has to be played on an
external link. Please use a different template, apart from the
one with video.
Image ID: Commented [M10R9]: Kindly Provide me more details on
Alt Text: the game to add here. SME has not given
Sample Template:
http://pandemic2.org/
OST
Screen Number: 178

Screen Title: Summary
Key learning points in this module are:
 Activities in Epidemiology include a variety of things that epidemiologists do in order to solve the
disease puzzle. These include, but are not limited to: Identifying risk factors, Monitoring diseases
over time, and being a resource person. Be sure to review the rest of these activities, which are
found in Chapter 1.
 Epidemics, Endemics, and Pandemics are terms used to describe the extent of a disease. Epidemics
occur in excess of what is normal in a community or region. A pandemic is an epidemic that affects
a region, country or continent! Finally, an endemic is an ongoing presence of a disease in a
community or region. The flu is an example but only if the pattern is consistent from year to year.
 The Epidemiology Triangle is a means of demonstrating how 4 factors interrelate. The factors
include 1) host, 2) agent, 3) environment, and 4) time.
 The Chain of Infection is a concept used throughout medicine. It demonstrates the pathway
taken by a disease pathogen. There are six points in the chain of infection and it is important to
understand each. They are 1) infectious agent, 2) reservoir, 3) portal of exit, 4) mode of
transmission, 5) portal of entry, and 6) susceptible host.
 Knowledge of Disease Transmission allows us to understand how proper infection and control
measures can benefit those who are sick. There are a variety of terms that need to be
understood in this area. They include direct and indirect transmission, airborne transmission, and
vector and vehicle
transmission.
 Understanding Levels of
Prevention including
primary and secondary
prevention help us
prevent diseases from
occurring – and if a
disease does occur, we
are able to prevent it
from spreading.
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Sample Template:
OST
Screen Number: 1823
Screen Title: Review Questions and Answers
What is primary prevention?
Type the most appropriate answer and select Show Answer to view a sample answer.
Primary prevention is preventing a disease or disorder before it happens

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SSample Template:
OST
Screen Number: 1924
List 3 methods of primary prevention
Health promotion, health education, and health protection

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Screen Number: 205
What does active primary prevention require?

Active primary prevention requires behavioural change on the individual’s part.
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Screen Number: 216

What are some examples of passive primary prevention?
Exercise, diet, stop smoking
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Screen Number: 227
Screen Title: What’s Next?
In the next module, we shall cover Chapters 3 and 4 that discuss the practical disease concepts in
epidemiology, and design strategies and statistical methods in descriptive epidemiology.
Commented [FEV11]: Please list out the textbook and all

Image ID: 527616331 the other websites that have been referred to in this
Sample Template: module using the APA style.
Commented [M12R11]: SME has not provided the same.
Kindly look into that

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<HCA 302>: <Healthcare Finance> : <Module 1>

Module Name Foundations of Epidemiology

Version Responsibility Date

Note to the Reviewer/SME:

1. Define epidemiology, descriptive and analytic epidemiology, epidemic, endemic, and

Screen Title: Topic 1: The Basics – Building your Epidemiology Vocabulary

To understand epidemiology, you must build

Healthy or passive carriers

Active primary prevention

Passive primary prevention

Characterization of the distribution of health-related states or events defines:

Select the correct option.

Correct option feedback:

Feedback for 1st incorrect try

Feedback for 2nd incorrect try

a. Epidemic – this is correct

Endemic is a disease that is said to endemic when it continually prevails in a region

Screen Title: Topic 2: The Epidemiology Triangle

Screen Title: Topic 2: The Epidemiology Triangle

Select each step to learn how to access the app.

Screen Title: Check your Understanding

Agents of infectious disease may be:

Select all the options that apply.

a. Bacteria – This is correct! -

Correct Option Feedback

That’s correct. All five options are right.

5. Factors in host susceptibility:

1. Reservoirs: humans and possibly monkeys

Screen Number: 910

Screen Title: Fact Sheet on Dengue

What is dengue hemorrhagic fever?

How is dengue diagnosed?

What is the treatment for dengue or dengue hemorrhagic fever?

Screen Number: 101

Screen Title: Fact Sheet on Dengue

What common is dengue and where is it found?

How is dengue transmitted?

Who has an increased risk of being exposed to dengue?

What can be done to reduce the risk of acquiring dengue?

Can epidemics of dengue hemorrhagic fever be prevented?

Screen Number: 112

Screen Title: Check your Understanding

Infectious Agent is the germ or pathogen that causes disease

Screen Number: 123

Screen Title: Check your Understanding

Screen Number: 134

Screen Title: Break the chain Video

Select play to watch the video

Screen Number: 145

Select play to watch the video

Screen Number: 156

Screen Title: Epidemic, Pandemic, Endemic? Video

Select play to watch the video

Screen Number: 167

Screen Number: 178

Screen Title: Summary

Key learning points in this module are:

Image ID: 687748648

What is primary prevention?

Primary prevention is preventing a disease or disorder before it happens

Screen Number: 1924

Screen Title: Review Questions and Answers

List 3 methods of primary prevention