DISCUSSION CONTENT Category Points % Description • • • Scholarly 13 22% • • • • • • Application 20 33% • • The student actively stimulates and sustains inquiry by making reflective insightful comments, asking thoughtful questions and/or engaging in a scholarly discussion. The student expresses a clear idea of the topic under discussion and sustains inquiry in order to explore relevant issues. The student recognizes values or values conflict as things that form the assumption basis of arguments and recognizes when it is important to acknowledge these values. The student recognizes the accuracy, logic, relevance, or clarity of statements. The student asks clarifying questions and knows when clarifying questions need to be asked. The student distinguishes fact from opinion. All components of discussion prompt addressed (met) in initial posting. The student’s writing conveys an understanding of significant ideas relevant to the issue under discussion. This is indicated by integration of course and weekly objectives, as well as readings from text and articles. All posts should make correct use of terminology, precise selection of the pieces of information required to make a point, correct and appropriate use of examples and counterexamples, demonstrations of which distinctions are important to make, and explanations that are concise and to the point. Information and knowledge are accurate. The student elaborates statements with accurate explanations, reasons, or evidence from the course and/or weekly objectives. • All postings integrate scholarly sources to support points consistently. • Interactive Dialogue Responds to ideas in a way that advances discussion with engagement, depth, rigor, and application. • Interacts with a professional tone and is able to express opinions with ownership and without judgement. • Chooses to include professional experience to the discussion board mindful of appropriateness and boundaries. Experience is integrated as it supports the discussion board topic and utilizes scholarly references to support overall topic. 10 16.6% 43 72% Total CONTENT Points= 43 pts % Description DISCUSSION FORMAT Category Points • APA 12 20% In text citations are formatted per APA 7th ed. • NR 503 Principles of Epidemiology Discussion

Reference list is formatted per APA 7th ed. • Spelling, grammar, and scholarly tone are per APA 7th ed. • Spelling / Grammar etc. Posts should utilize correct spelling and grammar (sentence structure and avoidance of slang or casual language) . 5 8% 17 28% Total FORMAT Points=17 pts 60 100% DISCUSSION TOTAL=60 points SELF-STUDY Course SS1978 Principles of Epidemiology in Public Health Practice Third Edition An Introduction to Applied Epidemiology and Biostatistics October 2006 Updated May 2012 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention (CDC) Office of Workforce and Career Development Atlanta, GA 30333 CONTENTS Acknowledgments………………………………………………………………………………………………….v Introduction ………………………………………………………………………………………………………. viii Lesson One: Introduction to Epidemiology Lesson Introduction …………………………………………………………………………………………… 1-1 Lesson Objectives ……………………………………………………………………………………………… 1-1 Major Sections Definition of Epidemiology …………………………………………………………………………… 1-2 Historical Evolution of Epidemiology …………………………………………………………….. 1-7 Uses ………………………………………………………………………………………………………….. 1-12 Core Epidemiologic Functions …………………………………………………………………….. 1-15 The Epidemiologic Approach ………………………………………………………………………. 1-21 Descriptive Epidemiology …………………………………………………………………………… 1-31 Analytic Epidemiology ……………………………………………………………………………….. 1-46 Concepts of Disease Occurrence ………………………………………………………………….. 1-52 Natural History and Spectrum of Disease………………………………………………………. 1-59 Chain of Infection ………………………………………………………………………………………. 1-62 Epidemic Disease Occurrence ……………………………………………………………………… 1-72 Summary …………………………………………………………………………………………………… 1-80 Exercise Answers …………………………………………………………………………………………….. 1-81 Self-Assessment Quiz ………………………………………………………………………………………. 1-85 Answers to Self-Assessment Quiz ……………………………………………………………………… 1-90 References ………………………………………………………………………………………………………. 1-93 Lesson Two: Summarizing Data Lesson Introduction …………………………………………………………………………………………… 2-1 Lesson Objectives ……………………………………………………………………………………………… 2-1 Major Sections Organizing Data …………………………………………………………………………………………… 2-2 Types of Variables ……………………………………………………………………………………….. 2-4 Frequency Distributions ………………………………………………………………………………… 2-7 Properties of Frequency Distributions …………………………………………………………… 2-11 Methods for Summarizing Data ……………………………………………………………………. 2-15 Measures of Central Location ………………………………………………………………………. 2-16 Measures of Spread …………………………………………………………………………………….. 2-36 Choosing the Right Measure of Central Location and Spread ………………………….. 2-53 Summary …………………………………………………………………………………………………… 2-58 Exercise Answers …………………………………………………………………………………………….. 2-59 Self-Assessment Quiz ………………………………………………………………………………………. 2-64 Answers to Self-Assessment Quiz ……………………………………………………………………… 2-69 References ………………………………………………………………………………………………………. 2-71 Introduction Page ii Lesson Three: Measures of Risk Lesson Introduction …………………………………………………………………………………………… 3-1 Lesson Objectives ……………………………………………………………………………………………… 3-1 Major Sections Frequency Measures …………………………………………………………………………………….. 3-2 Morbidity Frequency Measures ……………………………………………………………………. 3-10 Mortality Frequency Measures …………………………………………………………………….. 3-20 Natality (Birth) Measures ……………………………………………………………………………. 3-38 Measures of Association ……………………………………………………………………………… 3-39 Measures of Public Health Impact ………………………………………………………………… 3-48 Summary …………………………………………………………………………………………………… 3-51 Exercise Answers …………………………………………………………………………………………….. 3-52 Self-Assessment Quiz ………………………………………………………………………………………. 3-56 Answers to Self-Assessment Quiz ……………………………………………………………………… 3-62 References ………………………………………………………………………………………………………. 3-65 Lesson Four: Displaying Public Health Data Lesson Introduction …………………………………………………………………………………………… 4-1 Lesson Objectives ……………………………………………………………………………………………… 4-1 Major Sections Introduction to Tables and Graphs ………………………………………………………………….. 4-2 Tables …………………………………………………………………………………………………………. 4-3 Graphs ………………………………………………………………………………………………………. 4-22 Other Data Displays ……………………………………………………………………………………. 4-42 Using Computer Technology ……………………………………………………………………….. 4-63 Summary …………………………………………………………………………………………………… 4-66 Exercise Answers …………………………………………………………………………………………….. 4-72 Self-Assessment Quiz ………………………………………………………………………………………. 4-79 Answers to Self-Assessment Quiz ……………………………………………………………………… 4-84 References ………………………………………………………………………………………………………. 4-87 Lesson Five: Public Health Surveillance Lesson Introduction …………………………………………………………………………………………… 5-1 Lesson Objectives ……………………………………………………………………………………………… 5-1 Major Sections: Introduction …………………………………………………………………………………………………. 5-2 Purpose and Characteristics of Public Health Surveillance ………………………………… 5-4 Identifying Health Problems for Surveillance ………………………………………………….. 5-6 Identifying or Collecting Data for Surveillance………………………………………………. 5-13 Analyzing and Interpreting Data …………………………………………………………………… 5-23 Disseminating Data and Interpretations …………………………………………………………. 5-34 Evaluating and Improving Surveillance…………………………………………………………. 5-38 Summary …………………………………………………………………………………………………… 5-42 Appendix A. Characteristics of Well-Conducted Surveillance ……………………….. 5-43 Introduction Page iii Appendix B. Appendix C. Appendix D. Appendix E. CDC Fact Sheet on Chlamydia ……………………………………………….. 5-45 Examples of Surveillance ………………………………………………………. 5-48 Major Health Data Systems in the United States ……………………….. 5-52 Limitations of Notifiable Disease Surveillance and Recommendations for Improvement………………………………………… 5-53 Exercise Answers …………………………………………………………………………………………….. 5-57 Self-Assessment Quiz ………………………………………………………………………………………. 5-63 Answers to Self-Assessment Quiz ……………………………………………………………………… 5-68 References ………………………………………………………………………………………………………. 5-73 Lesson Six: Investigating an Outbreak Lesson Introduction …………………………………………………………………………………………… 6-1 Lesson Objectives ……………………………………………………………………………………………… 6-1 Major Sections: Introduction to Investigating an Outbreak ……………………………………………………….. 6-2 Steps of an Outbreak Investigation …………………………………………………………………. 6-8 Summary …………………………………………………………………………………………………… 6-57 Exercise Answers …………………………………………………………………………………………….. 6-59 Self-Assessment Quiz ………………………………………………………………………………………. 6-64 Answers to Self-Assessment Quiz ……………………………………………………………………… 6-71 References ………………………………………………………………………………………………………. 6-75 Glossary Introduction Page iv ACKNOWLEDGMENTS Developed by U.S. Department of Health and Human Services Centers for Disease Control and Prevention (CDC) Office of Workforce and Career Development (OWCD) Career Development Division (CDD) Atlanta, Georgia 30333 Technical Content Richard C. Dicker, MD, MSc, Lead Author, CDC/OWCD/CDD (retired) Fátima Coronado, MD, MPH, CDC/OWCD/CDD Denise Koo NR 503 Principles of Epidemiology Discussion

MD, MPH, CDC/OWCD/CDD Roy Gibson Parrish, II, MD Development Team Sonya D. Arundar, MS, CDC (contractor) Ron Teske, MS, CDC (contractor) Susan Baker Toal, MPH, Public Health Consultant Nancy M. Hunt, MPH, CDC (ORISE Fellow) Susan D. Welch, MEd, Georgia Poison Center Cassie Edwards, CDC (contractor) Planning Committee Christopher K. Allen, RPh, MPH, CDC W. Randolph Daley, DVM, MPH, CDC Patricia Drehobl, RN, MPH Sharon Hall, RN, PhD, CDC Dennis Jarvis, MPH, CHES, CDC Denise Koo, MD, MPH, CDC Graphics/Illustrations Sonya D. Arundar, MS, CDC (contractor) Lee Oakley, CDC (retired) Jim Walters, CDC Technical Reviewers Tomas Aragon, MD, DrPH, San Francisco Department of Public Health Diane Bennett, MD, MPH, CDC Danae Bixler, MD, MPH, West Virginia Bureau for Public Health R. Elliot Churchill, MS, MA, CDC (retired) Roxanne Ereth, MPH, Arizona Department of Health Services Stephen Everett, MPH, Yavapai County Community Health Services, Arizona Michael Fraser, PhD, National Association of County and City Health Officials Introduction Page v Nancy C. Gathany, MEd, CDC Marjorie A.Getz, MPHIL, Bradley University, Illinois John Mosely Hayes, DrPH, MBA, MSPH, Tribal Epidemiology Center United South and Eastern Tribes, Inc., Tennessee Richard Hopkins, MD, MSPH, Florida Department of Health John M. Horan, MD, MPH, Georgia Division of Public Health Christina M. Bruton Kwon, MSPH, Science Applications International Corporation, Atlanta Edmond F. Maes, PhD, CDC Sharon McDonnell, MD, MPH, Darmouth Medical School William S. Paul, MD, MPH, Chicago Department of Public Health James Ransom, MPH, National Association of County and City Health Officials Lynn Steele, MS, CDC Donna Stroup, PhD, MSc, American Cancer Society Douglas A. Thoroughman, PhD, MS CDC Kirsten T. Weiser, MD, Darmouth Hitchcock Medical School Celia Woodfill, PhD, California Department of Health Services Field Test Participants Sean Altekruse, DVM, MPH, PhD, U.S. Public Health Service Gwen A. Barnett, MPH, CHES, CDC Jason Bell, MD, MPH Lisa Benaise, MD, Med Immune, Inc., Maryland Amy Binggeli, DrPH, RD, CHES, CLE, Imperial County Public Health Department, California Kim M. Blindauer, DVM, MPH, Agency for Toxic Substances and Disease Registry R. Bong, RN, BSN, Federal Bureau of Prisons Johnna L. Burton, BS, CHES, Tennessee Department of Health Catherine C. Chow, MD, MPH, Hawaii Department of Health Janet Cliatt, MT, CLS(NCA), National Institutes of Health Catherine Dentinger, FNP, MS, New York City Department of Health and Mental Hygiene Veronica Gordon, BSN, MS, Indian Health Service, New Mexico Susan E. Gorman, PharmD, DABAT, CDC Deborah Gould, PhD, CDC Juliana Grant, MD, MPH, CDC Lori Evans Hall, PharmD, CDC Nazmul Hassan, MS, Food and Drug Administration Daniel L. Holcomb, BS, Agency for Toxic Substances and Disease Registry Asim A. Jani, MD, MPH FACP, CDC Charletta L. Lewis, BSN, Wellpinit Indian Health Service, Washington Sheila F. Mahoney, CNM, MPH, National Institutes of Health Cassandra Martin, MPH, CHES, Georgia Department of Human Resources Joan Marie McFarland, AS, BSN, MS, Winslow Indian Health Care Center, Arizona Rosemarie McIntyre, RN, MS, CHES, CDC Introduction Page vi Gayle L. Miller, DVM, Jefferson County Department of Health and Environment, Colorado Long S. Nguyen, MPH, CHES, NIH Paras M. Patel, RPh, Food and Drug Administration Rossanne M. Philen, MD, MS, CDC Alyson Richmond, MPH, CHES, CDC (contractor) Glenna A. Schindler, MPH, RN, CHES, Healthcare Services Group, Missouri Sandra K. Schumacher, MD, MPH, CDC Julie R. Sinclair, MA, DVM, MPH, CDC Nita Sood, RPh, PharmD, U.S. Public Health Service P. Lynne Stockton, VMD, MS, ELS(D), CDC Jill B. Surrency, MPH, CHES, CDC (contractor) Joyce K. Witt, RN, CDC Introduction Page vii INTRODUCTION This course was developed by the Centers for Disease Control and Prevention (CDC) as a self-study course. Continuing education is available for certified public health educators, nurses, physicians, pharmacists, veterinarians, and public health professionals. CE credit is available only through the CDC/ATSDR Training and Continuing Education Online system at http://www.cdc.gov/TCEOnline. To receive CE credit, you must register for the course (SS1978) and complete the evaluation and examination online. You must achieve a score of 70% or higher to pass the examination. If you do not pass the first time, you can take the exam a second time. For more information about continuing education, call 1-800-41-TRAIN (1-800-4187246) or by e-mail at ce@cdc.gov. Course Design This course covers basic epidemiology principles, concepts, and procedures useful in the surveillance and investigation of health-related states or events. It is designed for federal, state, and local government health professionals and private sector health professionals who are responsible for disease surveillance or investigation. A basic understanding of the practices of public health and biostatistics is recommended. Course Materials The course materials consist of six lessons. Each lesson presents instructional text interspersed with relevant exercises that apply and test knowledge and skills gained. Lesson One: Introduction to Epidemiology Key features and applications of descriptive and analytic epidemiology Lesson Two: Summarizing Data Calculation and interpretation of mean, median, mode, ranges, variance, standard deviation, and confidence interval Lesson Three: Measures of Risk Calculati …