DHA 731 WEEK 4 Epidemiologic Tools and Assessments Summary

Human health threats posed by airborne pathogens are difficult to handle for healthcare responders due to the fact that the contaminated area is not immediately recognizable. By means of wind dispersion modeling, it is possible to estimate the extent and geographical position of hazardous areas and health impact. Contemporary modeling tools can run on standard PCs, with short processing time and with easy-to-use interfaces. This enables health professionals without modeling experience to assess consequences of dispersion incidents, for example, from accidental releases from industries, shedding of pathogens from infectious animals or humans, as well as intentional releases caused by terrorist activity. Dispersion assessments can provide response managers with a chance to get on top of events. In the absence of modeling, reliable estimates of hazard areas may not be available until no earlier than the appearance of the first cases or after time-consuming sampling and laboratory analysis. In this article, the authors describe the concept of using wind dispersion assessments in epidemiological field investigations of naturally occurring disease outbreaks, as well as for bioterror scenarios. They describe the specifications of user friendly and real-time functional wind dispersion modeling systems that can serve as decision support tools during outbreak investigations and outline some of the currently available software packages.

Epidemiology offers powerful tools to quantify the degree to which risk factors and humanitarian interventions affect population health in a crisis. These tools include surveys, surveillance, analysis of programme data, and rapid assessment. Often different tools can provide information about the same health outcome or indicator of interest; however, the types of information provided by different tools may differ. As a result, a strategic choice about which tool to use is often required.

In crises, epidemiology (and allied disciplines such as social science and demography) can achieve the following tasks:

Benchmarking the severity of a crisis and monitoring its evolution over time. Mortality is the main indicator of the severity of crises, since it is the ultimate outcome of increased exposure, susceptibility, disease progression and case-fatality. Mortality can be measured either prospectively (see pages on Mortality surveillance and Surveillance – Prospective death reporting) or retrospectively (see pages on Surveys – Retrospective data collection).
Measuring the degree to which different risk factors are present in the crisis-affected community, and the degree to which populations benefit from interventions to minimise these risk factors. The proportion of displaced people in a newly created camp without access to adequate sanitation facilities (i.e. exposed to the risk factor), and the proportion with such access (i.e. protected by the intervention), are two faces of the same coin. By measuring the latter, we also get insight into the former. Depending on the risk factor in question, epidemiologists will measure either the risk factor itself (e.g. overcrowding) or the coverage of the intervention (e.g. water and sanitation, vaccination, or health services).
Monitoring trends in the occurrence of specific diseases over time and identifying emergent threats in a timely fashion (see Morbidity surveillance).

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