SPH 697 Epidemiology and Control of Infectious Diseases Winter Term 2016 Course Instructor: Teaching Assistant: Time: Place: Contact:

Stan Houston, MD Rhianna Charchuk Wednesday 4:00 – 7:00 pm (13 lectures) Education 262 Stan Houston: (780) 407-8035 [email protected]

Approach to Be Taken For This Course: This survey course provides an introduction to the epidemiology of a broad spectrum of communicable diseases and the application of this knowledge to their prevention and control. Specific disease entities will be used to illustrate the principles involved in the epidemiology and control of various types of infectious disease including fecal/orally transmitted diseases, respiratory diseases, blood borne pathogens, vector-borne diseases, vaccine preventable diseases, etc., including reference to the social, political and economic determinants of these infections and operational aspects of their control. The course will encourage students to apply the principles they learn to the specific characteristics of a communicable disease, in order to develop surveillance and control measures for that specific infection. While we strive to minimize unnecessary biologic or clinical detail, the course also highlights how some disease-specific biologic knowledge is necessary in order to understand the impact and epidemiology of a disease and to implement effective control strategies—you can’t control malaria transmission if you don’t realize that a mosquito is involved. The impact of recent developments in infectious diseases, including emerging pathogens and molecular epidemiology will be addressed. Through the participation of public health practitioners in the course, public health activities such as surveillance, outbreak investigation and control measures both in the community and in the health care setting will be addressed. There will be an introduction to the application of modeling techniques to investigation of infectious diseases and consideration of economic, legal and ethical implications of infectious disease control interventions. The course strives to combine a global perspective with consideration of the public health aspects of infectious disease priorities in Alberta and Canada. Course Requirements: Written consent of the course instructor is required. PHS 590 (Introduction to Epidemiology) or PHS 596 (Epidemiology Methods I), and PHS 598 (Biostatistics I) or their equivalents will be required in most cases. Alternatively, an educational background or substantial experience in infectious diseases or medical microbiology may be considered adequate preparation for this course after discussion with the instructor. Minimum class size is about 6; maximum is about 20.

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Method of Course Delivery and Expectations: While retaining the content emphasis that has been developed over 10 years, the delivery model for the majority of the course has been modified to maximize the utility of in-class time and provide an opportunity to delve more deeply into the course material and discuss implications including operational and ethical questions, at a graduate level. The lectures provided by Dr. Houston as well as Drs. Cooper and Hawkes will be posted in advance with both PowerPoint and accompanying audio (Podcast), ending with some suggested questions and discussion points or other preparation for in class activities (the PowerPoint format will also be posted which will contain some key references and enable you to make printouts for note taking). You will be able to watch these presentations at your own pace; in fact we strongly encourage you to review them in digestible bits—logical divisions or stopping points will be apparent in most presentations. Students will be expected to have viewed the presentations in advance of the class, to have done any further reading, investigation or reflection they feel warranted by the topic and the material, and to come prepared for the upcoming class discussion or other planned activity. A short quiz will be posted for each class, which can be answered on line. Cumulative marks for these quizzes will contribute 10% of your total mark. During the class, the speaker will begin with a brief review or highlighting of key issues and address questions or clarification from the class before engaging in the focussed class discussion/activity. The duration of each podcast will approximate the amount of time allotted to the corresponding topic so that the out of class time commitment for this class, including the two assignments should not exceed the 2-3 hours of out-of-class time/hour of in-class time expected by the School of Public Health. Guest lecturers with specific expertise will supplement the expertise of the course co-instructors. Guest lecturers in the course will be offered the opportunity to deliver their topics as described above, but may choose to continue in the more traditional model of lecturing in class. An online discussion forum will be hosted on the class website on eClass. Students are encouraged to participate in this, to bring news or issues which they think may be of interest to the class, to our attention, or to expand discussion of topics raised in class. Participation in this discussion will not be formally evaluated. Auditing students admitted to the class must meet pre-requisites for admission. Course objectives: Using the understanding gained from study of examples of selected communicable diseases, students will be able to: 1. Demonstrate a broad grasp of the impact of infectious diseases generally, of major routes of transmission, and of specific major infectious disease entities, both globally and in the Canadian context. 2. Apply knowledge of the biology and epidemiology of various types of infectious diseases to their investigation and control, by vaccine, treatment of infectious cases, or other methods. 3. Have an overview of the operation of public health institutions including the laboratory, in the control of infectious diseases. 4. Understand the social context for the prevalence, transmission and control of infectious diseases. 5. Understand the application of epidemiological methods to the study of a broad range of infectious diseases. 6. Describe the essential features of an epidemic (outbreak) investigation. 7. Understand the significance of surveillance methods in infectious diseases control.

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8. Appreciate some of the potential uses of modelling techniques in infectious diseases. 9. Appreciate the legal and ethical issues unique to infectious diseases research, service delivery, and control. 10. Identify and locate the key literature and resources for lifetime learning skills in infectious diseases epidemiology, including web-based information. Evaluation: To be based on four components and assessed on the University of Alberta’s four-point system: 1. 10% for a two-page essay to be completed prior to reading week, on a topic selected by the student. 2. 10% for the cumulative results of the weekly quizzes. 3. 25% for one in-class, closed-book examination two hours in duration, immediately after reading week, consisting of short answers and paragraph answers, in which students will be asked to apply the content of classes 1-6. 4. 25% for an end of term exam of the same format based on the content of classes 7-12. 5. 30% for a take-home PAPER/ESSAY requiring that a problem be addressed in a maximum of 8 typed pages (1.5 spacing with 1 inch margins all round, 11- or 12-point font) with up to two pages of references. The topic or question will be chosen from a list of possible topics assigned early after completion of the mid-term exam and the essay will be due within a week of the final lecture. This essay will involve application of the student’s knowledge about the epidemiology and control of infectious diseases to the development of a program in a real or hypothetical setting. Being late on PAPER/ESSAY submission will be penalized 5% per day, including weekend days. Plagiarism will result in automatic failure on the particular work and possible expulsion from the University. Suggested Resources: 1. Infectious Disease Epidemiology: Theory and Practice. Kenrad E. Nelson, Carolyn Masters Williams Aspen Publishers, Inc., MD, 2nd Ed 2007. 2. Control of Communicable Diseases Manual. American Public Health Association and WHO updated +/- every 2 years. (also available in smart phone version) 3. Promed (listserve) Resources in Infectious/Communicable Disease Epidemiology on the Internet and elsewhere must be explored.

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Class Schedule 2016

Week 1: Wednesday, January 6 Importance, Impact History of Infectious Diseases Means of Transmission, Host Response Disease Elimination and Eradication

Lecturer

Hours

Stan Houston Stan Houston Stan Houston

1 1 1

Week 2: Wednesday, January 13 Role of the Lab Graham Tipples Vaccination: Impact, Principles and Examples Michael Hawkes **First Paper - Topic Handed Out At This Class, Due Before Reading Week

1 2

Week 3: Wednesday, January 20 Outbreak Investigation Exercise in Outbreak Investigation Disease Surveillance

Kim Simmonds Kim Simmonds Kim Simmonds

1 1 1

Week 4: Wednesday, January 27 Emerging Infectious Diseases Molecular Epidemiology Journal Club

Stan Houston Ryan Cooper Ryan Cooper

1 1 1

Week 5: Wednesday, February 3 HIV Insect Vector Borne Disease

Stan Houston Stan Houston

2 1

Geoff Taylor Joanna Oda Stan Houston

1 1 1

Week 6: Wednesday, February 10 Hospital Infection Control/Nosocomial Infection Influenza, Including Pandemic Flu Helminth Diseases **First Assignment Due READING WEEK: February 16-19 Week 7: Wednesday, February 24 Mid-term Exam 4:00 – 6:00 pm (material of weeks 1-6)

2

Week 8: Wednesday, March 2 Mathematical Modeling Problem Solving Session, Modelling Class Exercise **Hand Out Essay Topics Week 9: Wednesday, March 9 Zoonoses STIs Blood-Borne Pathogens

4

Sabrina Plitt Sabrina Plitt Sabrina Plitt

1 1 1

Stan Houston Ami Singh Ryan Cooper

1 1 1

Week 10: Wednesday, March 16 Epidemiology of Drug Resistance Infectious Diseases Causing Cancer Paediatric Pneumonia

Stan Houston Stan Houston Michael Hawkes

1 1 1

Week 11: Wednesday, March 23 Malaria Diarrheal, Fecal/Oral, and Water-Borne Disease Water Quality

Michael Hawkes Stan Houston Nelson Fok

1 1 1

Week 12: Wednesday, March 30 TB Problem Solving Session: Study Type, Control

Ryan Cooper Ryan Cooper

1 2

Tracey Bailey, Donna Wilson, Joanna Oda

2

Week 13: Wednesday, April 6 Law, Ethics and Risk Communication in Infectious Diseases Epidemiology and Control **Essays Due Week 14: Wednesday, April 13 Final Exam 4:00 – 6:00 pm

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Total: 39 Lecture hours including midterm exam

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