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Glossary in Epidemiology

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 Glossary in Epidemiology

Compiled by
Dr Vinodh Kumar O.R
Dr D.K.Sinha
Dr B.R.Singh

Division of Epidemiology
ICAR-Indian Veterinary Research Institute
Izatnagar-243 122, Uttar Pradesh

1
A

Aetiology (Etiology): (The study of) the causes of disease.

Aetiological fraction: The reduction in disease when a risk factor is removed.

Absolute risk: It is risk of a disease is your risk of developing the disease over a time
period.

Abiotic factors: These are non-living chemical and physical parts of the environment
that affect living organisms and the functioning of ecosystems.

Accessory reservoir: A reservoir that contributes to the maintenance of a pathogen in

nature but is not the primary reservoir for such agent.

Accuracy: It is the extent to which a measurement reflects the true value. It is the
tendency of test measurement to centre around the true value.

Acquired immunity: The inherited potential to resist a disease or infection.

Active immunity: Resistance to a disease, developed in response to an antigen (an

infecting agent or a vaccine) and usually characterized, or distinguished, by the presence
of antibodies produced by the host

Active surveillance: The process in which health departments (or responsible agencies)
contact clinicians, laboratories, or other data sources to seek out information about
disease cases.

Age-adjustment/Age- standardization: A technique used to compare populations that

are quite different in age.

Age-adjusted mortality rate: A mortality rate statistically modified to eliminate the

effect of different age distributions in the different populations.

Agent: A factor, such as a microorganism, chemical substance, or form of radiation, whose

presence, excessive presence, or (in deficiency diseases) relative absence is essential for
the occurrence of a disease.

Age Specific rate: A rate limited to a particular age group. The numerator is the number
of occurrences in that age group; the denominator is the number of persons in that age
group in the population.

Age-specific mortality rate: A mortality rate limited to a particular age group. The
numerator is the number of deaths in that age group; the denominator is the number of
persons in that age group in the population.

Aggregative fallacy: An erroneous application to individuals of a causal relationship

observed at the group level. A type of ecological fallacy (sometimes just a synonym).

2
Airborne transmission: The spread of an infection by droplets or dust, with a particle
spread of more than three feet through the air. It is considered to be a form of indirect
transmission.

Analysis of variance (ANOVA): A statistical technique that isolates and assesses the
contribution of categorical independent variables to the variance of the mean of a
continuous dependent variable. The observations are classified according to their
categories for each of the independent variables, and the differences between the
categories in their mean values on the dependent variable are estimated and tested.

Analytic epidemiology: A focused study of the determinants of disease or reasons for

high or low frequency of disease in specific groups. The aspect of epidemiology
concerned with the search for health-related causes and effects. Uses comparison groups,
which provide baseline data, to quantify the association between exposures and
outcomes, and test hypotheses about causal relationships. Analytic epidemiology is
search for health-related causes and effects.

Analytical sensitivity: It refers to the ability of an assay to detect minimum detectable

concentration of a target antibody or antigen.

Analytical specificity: It refers to the ability of an assay to measure particular organism

or substance rather than others.

Analytic study: A comparative study intended to identify and quantify associations, test
hypotheses, and identify causes. Two common types are cohort study and case-control
study.

Anamorphic map: A diagrammatic method of displaying administrative jurisdictions of a

country or any other region in two-dimensional “maps” with areas proportional to any
statistic related to the region.

Antenatal (Prenatal): The period between conception and birth.

Anthropurgic ecosystem: It is the type of ecosystem created by man.

Antibody: A protein produced in the blood of vertebrates following exposure to

an antigen. The antibody binds specifically to the antigen and thus stimulates its
inactivation by other parts of the immune system.

Antigenic drift: It is a mechanism for variation in viruses that involves the accumulation
of mutations within the genes that code for antibody-binding sites.

Antigenic shift: It is the process by which two or more different strains of a virus, or
strains of two or more different viruses, combine to form a new subtype having a mixture
of the surface antigens of the two or more original strains.

Applied epidemiology: The application or practice of epidemiology to address public

health issues.

3
Assessment: Evaluation or study. For example, a community health assessment would be
a study, or evaluation, of the health of a community.

Association: Statistical relationship between two or more events, characteristics, or

other variables.

Attack rate: A variant of an incident rate, applied to a narrowly defined population

observed for a limited period of time, such as during an epidemic.

Attenuation: It is the process by which makes an infectious agent harmless or less

virulent.

Attributable fraction: It is the proportion of disease in the exposed group that is due to
exposure. AF is calculated as the proportion that the attributable risk represents within
total disease risk in exposed individuals.

Attributable proportion: A measure of the public health impact of a causative factor;

proportion of a disease in a group that is exposed to a particular factor which can be
attributed to their exposure to that factor.

Attributable risk (rate): It is defined as the increase or decrease in the risk (or rate) of
disease in the exposed group that is attributable to exposure.

Autochthonous ecosystem: It is the type of ecosystem e coming from land itself.

Average length of stay: The average length of stay per discharged patient is computed
by dividing the total number of hospital days for a specified group by the total number of
discharges for that group.

Bar chart: A visual display of the size of the different categories of a variable. Each
category or value of the variable is represented by a bar. The lengths of the bars
represent frequencies of each group of observations.

Benefit –cost ratio or cost - benefit analysis: It is a ratio between the amount of monetary
gain realized by performing a project versus the amount it costs to execute the project.

Bias: A flaw in either the study design or data analysis that leads to erroneous results.
Bias is the deviation of results or inferences from the truth, or processes leading to such
systematic deviation. Any trend in the collection, analysis, interpretation, publication, or
review of data that can lead to conclusions that are systematically different from the
truth.

Bimodal distribution: A distribution that has two distinct modes, or peaks.

4
Biologic transmission: The indirect vector-borne transmission of an infectious agent in
which the agent undergoes biologic changes within the vector before being transmitted to
a new host.

Biome: A large naturally occurring community of flora and fauna occupying a major
habitat. Major biotic communities are biomes. e.g. forest or tundra.

Biosecurity: It is the management-practice activities that reduce the opportunities for

infectious agents to gain access to, or spread within, a food animal production unit.

Biotic community or Biocenosis: A biotic community is the collection of living

organisms (plants, animals and the microorganisms) in a biotope.

Biotope: It is an area of uniform environmental conditions providing a living place for a

specific collection of plants and animals. Biotope is almost synonymous with the
term habitat.

Box plot/Box and whiskers plot: A visual display that summarizes data using a ``box
and whiskers'' format to show the minimum and maximum values (ends of the whiskers),
interquartile range (length of the box), and median (line through the box).

Carrier: A person or animal without apparent disease who harbors a specific infectious
agent and is capable of transmitting the agent to others. The carrier state may occur in an
individual with an infection that is inapparent throughout its course (known as
asymptomatic carrier), or during the incubation period, convalescence, and
postconvalescence of an individual with a clinically recognizable disease. The carrier state
may be of short or long duration (transient carrier or chronic carrier).

Case: In epidemiology, a countable instance in the population or study group of a

particular disease, health disorder, or condition under investigation. Sometimes, an
individual with the particular disease.

Case-control study: A type of observational analytic study. Enrolment into the study is
based on presence (``case'') or absence (``control'') of disease. Characteristics such as
previous exposure are then compared between cases and controls.

Case-crossover study: In which a set of cases (subjects) is identified and a period of time
before the onset of disease is selected (termed the case window) wherein the exposure to
the risk factor of interest is evaluated. For each subject a second, non-overlapping time
window (the control window) of the same length as the case window is selected, during
which the subject did not experience the disease.

Case definition: A set of standard criteria for deciding whether a person has a particular
disease or health-related condition, by specifying clinical criteria and limitations on time,
place, and person.

5
Case-fatality rate: The proportion of persons with a particular condition (cases) who die
from that condition. The denominator is the number of incident cases; the numerator is
the number of cause-specific deaths among those cases.

Case report study: A type of descriptive study that consists of a careful, detailed profile
of an individual patient.

Case series study: A type of descriptive study that describes characteristics of number of
patients with a given disease.

Causality: The relating of causes to the effects they produce. Some of the criteria for
inferring a causal relationship between an implicated food and illness include: strength of
association, consistency of the observed association, temporal sequence of events
biological plausibility of the observed association, effect of removing the exposure, dose-
response relationships, and the exclusion of alternate explanations.

Cause of disease: A factor (characteristic, behavior, event, etc.) that directly influences
the occurrence of disease. A reduction of the factor in the population should lead to a
reduction in the occurrence of disease.

Cause-specific mortality rate: The mortality rate from a specified cause for a
population. The numerator is the number of deaths attributed to a specific cause during a
specified time interval; the denominator is the size of the population at the midpoint of
the time interval.

Census: The enumeration of an entire population, usually with details being recorded on
residence, age, sex, occupation, ethnic group, marital status, birth history, and
relationship to head of household.

Chance: Unexpected, random, or unpredictable.

Chain of infection: A process that begins when an agent leaves its reservoir or host
through a portal of exit, and is conveyed by some mode of transmission, then enters
through an appropriate portal of entry to infect a susceptible host.

Chi square test: A test of statistical significance. A Chi Square (χ2) test looks at the
difference between what we observe in the data and what we would expect if the
exposure was not associated with the illness.

Circular epidemiology: Circular epidemiology can be defined as the continuation of

specific types of epidemiologic studies beyond the point of reasonable doubt of the true
existence of an important association or the absence of such an association. Circular
epidemiology is an extreme example of studies of the consistency of associations.

Class interval: A span of values of a continuous variable which are grouped into a single
category for a frequency distribution of that variable.

Clinical disease: A disease that has been identified by its symptoms and features.

6
Clinical trial: A clinical trial is an experimental study with patients as subjects. The goal
either is to evaluate a potential cure to prevent disease sequelae such as death or
disability.

Climate: It is the statistics of weather, usually over a 30-year interval of particular

location. The weather can change in just a few hours; climate takes hundreds, thousands,
even millions of years to change.

Cluster: An aggregation of cases of a disease or other health-related condition,

particularly cancer and birth defects, which are closely grouped in time and place. The
number of cases may or may not exceed the expected number; frequently the expected
number is not known.

Cohort: A well-defined group of people who have had a common experience or exposure,
who are then followed up for the incidence of new diseases or events, as in a cohort or
prospective study. A group of people born during a particular period or year is called a
birth cohort.

Cohort study: A type of observational analytic study. It involves comparing disease

incidence over time between groups (cohorts) that are found to differ on their exposure
to a factor of interest. Cohort studies are either prospective or retrospective Enrolment
into the study is based on exposure characteristics or membership in a group. Disease,
death, or other health-related outcomes are then ascertained and compared.

Colonized: A carrier state that occurs when a person is not infected with a pathogen, but
simply has it on the skin or mucous membrane.

Common source outbreak: An outbreak that results from a group of persons being
exposed to a common noxious influence, such as an infectious agent or toxin. If the group
is exposed over a relatively brief period of time, so that all cases occur within one
incubation period, then the common source outbreak is further classified as a point
source outbreak. In some common source outbreaks, persons may be exposed over a
period of days, weeks, or longer, with the exposure being either intermittent or
continuous.

Communicable disease: An infectious disease transmitted from an infected person,

animal, or reservoir to a susceptible host through an intermediate plant, animal, or the
inanimate environment.

Communicable period: The period of time during which an infected host (person)
remains capable of passing along the infective agent (for example, a virus).

Confidence interval: A range of values for a variable of interest, e.g., a rate, constructed
so that this range has a specified probability of including the true value of the variable.
The specified probability is called the confidence level, and the end points of the
confidence interval are called the confidence limits. The statistical values described in this
factsheet are frequently presented with upper and lower confidence limits. Confidence
limits can be used as a guide to assess whether there is a significant difference between

7
samples. The usual degree of confidence presented is 95% i.e. the statistic presented is
95% certain to fall within the upper and lower confidence limits.

Confidence limit: The minimum or maximum value of a confidence interval.

Confounding: The distortion of the association between an exposure and a health

outcome by a third factor that is related to both. This can occur when an association
between a risk factor and disease can be explained by a factor associated with both
disease and risk factor. For example, an association between smoking, alcohol
consumption, and lung cancer is observed.

Consistency: Reliability or uniformity of results or events.

Contact: Exposure to a source of an infection, or a person so exposed.

Contact transmission: The spread of an agent directly (person-to-person), indirectly, or

by airborne droplets from less than three feet away

Contagious: Capable of being transmitted from one person to another by contact or close
proximity.

Contingency table: A two-variable table with cross-tabulated data.

Control: A comparison group of people in a case-control study who do not have the
disease or condition being studied. In a case-control study, comparison group of persons
without disease.

Correlation: The degree to which two or more measurements show a tendency to vary
together. A measurement of the association or relationship between variables.

Cross-sectional study/Horizontal study: A type of descriptive study in which a set of

individuals are studied at a single point in time (or over a defined period of time) for the
prevalence of disease. Both risk factors and disease status are ascertained at the same
time. Cross sectional studies commonly involve surveys to collect data.

Crude rate: The rate calculated for an entire population.

Crude mortality rate: The mortality rate from all causes of death for a population.

Cumulative frequency: In a frequency distribution, the number or proportion of cases or

events with a particular value or in a particular class interval, plus the total number or
proportion of cases or events with smaller values of the variable.

Cumulative frequency curve: A plot of the cumulative frequency rather than the actual
frequency for each class interval of a variable. This type of graph is useful for identifying
medians, quartiles, and other percentiles.

Cumulative incidence: The risk of new disease occurrence is quantified using

cumulative incidence, also called incidence risk. It is defined as the proportion of disease-

8
free individuals developing a given disease over a specified time, conditional on that
individual’s not dying from any other disease during the period.

Data: Numerical information. Data is a plural term; the singular is datum

Death-to-case ratio: The number of deaths attributed to a particular disease during a

specified time period divided by the number of new cases of that disease identified during
the same time period.

Demography/Demographic information: The ``person'' characteristics--age, sex, race,

and occupation--of descriptive epidemiology used to characterize the populations at risk.

Denominator: The lower portion of a fraction used to calculate a rate or ratio. In a rate,
the denominator is usually the population (or population experience, as in person-years,
etc.) at risk.

Dependent variable/predictor: A variable that may be predicted by or caused by one or

more other variables, called independent variables. In a statistical analysis, the outcome
variable(s) or the variable(s) whose values are a function of other variable(s).

Deterministic model: A mathematical model in which the parameters and variables are
not subject to random fluctuations, so that the system is at any time entirely defined by
the initial conditions chosen

Descriptive epidemiology: The aspect of epidemiology concerned with organizing and

summarizing health-related data according to time, place, and person.

Descriptive statistics: Quantitative, or numerical, information used to describe a set of

observed cases.

Detection bias: This type of bias can occur when persons with a risk factor are more
likely to have disease detected because of more intense follow-up.

Determinant: Any factor, whether event, characteristic, or other definable entity, that
brings about change in a health condition, or in other defined characteristics.

Discrete variable: It is a variable for which there is a definite distance from one value of
the variable to the next possible value.

Direct transmission: The immediate transfer of an agent from a reservoir to a

susceptible host by direct contact or droplet spread.

Disease burden: The effect of a health problem measured by financial cost, death, illness,
or other indicators.

9
Disease investigation/ Outbreak investigation: The investigation of the occurrence of
a disease in a specific group of people.

Distribution: In epidemiology, the frequency and pattern of health-related

characteristics and events in a population. In statistics, the observed or theoretical
frequency of values of a variable.

Dot plot/dot map: A visual display of the actual data points of a non-continuous variable.
In other words it is a visual display of the specific data points of a variable that has a finite
number of values, such as race or sex.

Droplet nuclei: The residue of dried droplets that may remain suspended in the air for
long periods, may be blown over great distances, and are easily inhaled into the lungs and
exhaled.

Droplet spread: The direct transmission of an infectious agent from a reservoir to a

susceptible host by spray with relatively large, short-ranged aerosols produced by
sneezing, coughing, or talking.

Ecological (or correlational) study: A type of descriptive study involving the

comparison of disease frequency (incidence or prevalence) between populations that are
different with respect to one or more risk factors of interest. The risk factor information
is not known for individual subjects, but rather as a total population characteristic.

Ecological epidemiology: A branch of epidemiology which views disease as a result of

the ecological interactions between populations of hosts and parasites.

Ecological fallacy: With an ecological study, the risk factor information is not known for
individual subjects, but rather as a total population characteristic. For example, an
ecological study may find that Japanese people have a high rate of stomach cancer and
also a high rate of rice consumption. However, with an ecological study, it is not know if
the same individuals who eat rice are the same as those who have stomach cancer.

Ecological interfaces: An ecological interface is a junction of two ecosystems. Infectious

diseases can be transmitted across these interfaces.

Ecological mosaics: An ecological mosaic is a modified patch of vegetation, created by

man, within a biome that has reached a climax.

Effect modification: This refers to variation in the magnitude of a measure of exposure

effect across levels of another variable.

Effectiveness: The degree, degree to which an intervention or program produces the

intended or expected results under real world conditions.

Efficacy: The degree to which an intervention or program produces the intended or

expected results under ideal conditions.

10
Endemic fadeout: Parasite extinction occurring because endemic levels are so low that it
is possible for small stochastic fluctuations to remove all parasites.

Endemic disease: The constant presence of a disease or infectious agent within a given
geographic area or population group; may also refer to the usual prevalence of a given
disease within such area or group.

Environment: The third part of the epidemiological triangle, which brings the other two
parts of the triangle—the host (or, person) and the agent (or, virus)—together so that a
disease occurs.

Environmental factor: An extrinsic factor (geology, climate, insects, sanitation, health

services, etc.) which affects the agent and the opportunity for exposure.

Epidemic: The occurrence of more cases of disease than expected in a given area or
among a specific group of people over a particular period of time.

Epidemic curve: A histogram or graph that shows the course of a disease outbreak or
epidemic by plotting the number of cases by time of onset.

Epidemic fadeout: Parasite extinction occurring because numbers are so low

immediately following an epidemic that it is possible for small stochastic fluctuations to
remove all parasites

Epidemic period: A time period when the number of cases of disease reported is greater
than expected.

Epidemiologic triad/ Epidemiological triangle: The traditional model of infectious

disease causation. It includes three components: an external agent, a susceptible host, and
an environment that brings the host and agent together, so that disease occurs.

Epidemiology: The study of distribution and determinants of health-related states or

events in specified populations, and the application of this study to the control of health
problems.

Epiphytotic: An epidemic in a plant host population.

Epizootiology: It is the study of disease in animal populations and of factors that

determine its occurrence.

Equilibrium: A state in which a system is not changing. A population size might be at

a static equilibrium at which nothing is happening (there are no births or deaths) or
a dynamic equilibrium at which different processes are balanced (there are the same
numbers of births and deaths). More generally, the state to which a system eventually
evolves, for example sustained periodic oscillations, might be called an equilibrium.

Equivalent Average Death rate (EADR): In this method of adjustment each age-specific
rate is weighted with the corresponding interval length rather than the number of people
for which the rate is computed. It is measure of mortality in a dynamic population. It is

11
calculated by number of animals died divided by total number of animals days multiplied
by 1000. It is usually expressed as EADR per 1000 animal days.

Equivalent Average Morbidity rate (EAMR): In this method of adjustment each age-
specific rate is weighted with the corresponding interval length rather than the number
of people for which the rate is computed. It is measure of morbidity in a dynamic
population. It is calculated by number of animals morbid divided by total number of
animals days multiplied by 1000. It is usually expressed as EADR per 1000 animal days.

Evaluation: A process that attempts to determine as systematically and objectively as

possible the relevance, effectiveness, and impact of activities in the light of their
objectives.

Experimental study: A study in which the investigator specifies the exposure category
for each individual (clinical trial) or community (community trial), then follows the
individuals or community to detect the effects of the exposure.

Exposed (group): A group whose members have been exposed to a supposed cause of
disease or health state of interest, or possess a characteristic that is a determinant of the
health outcome of interest.

Exponential growth: An increase in which the rate of growth is always proportional to

the amount of material remaining; the constant of proportionality is the rate constant.

False-negative: A negative test result for a person who actually has the condition.

False-positive: A positive test result for a person who actually does not have the
condition.

Foodborne transmission: A type of disease transmission in which the infectious agent

(which can be bacteria, parasites, viruses, fungi and their products, or toxic substances
not of microbial origin) is passed on through food.

Fomite: An inanimate object that can be used to transmit an infectious agent. This may be
contaminated transfusion products or injections, towels or bedding, surgical instruments,
or contaminated food, water, or air

Frequency distribution: A complete summary of the frequencies of the values or

categories of a variable; often displayed in a two column table: the left column lists the
individual values or categories, the right column indicates the number of observations in
each category.

Frequency polygon: A graph of a frequency distribution with values of the variable on

the x-axis and the number of observations on the y-axis; data points are plotted at the
midpoints of the intervals and are connected with a straight line.

12
Graph: A way to show quantitative data visually, using a system of coordinates.

Health: A state of complete physical, mental, and social well-being and not merely the
absence of disease or infirmity.

Health indicator: A measure that reflects, or indicates, the state of health of persons in a
defined population, e.g., the infant mortality rate.

Health information system: A combination of health statistics from various sources,

used to derive information about health status, health care, provision and use of services,
and impact on health.

Herd immunity: The resistance of a group to an infectious agent. This group resistance
exists because a high proportion of people in the group are immune to the agent. Herd
immunity is based on having a substantial number of people who are immune, which
reduces the probability that they will come into contact with an infected person. By
vaccinating large numbers of people in a population to protect them from smallpox, for
example, health officials used herd immunity to control and eradicate the disease.

High-risk group: A group in the community with an elevated risk of disease.

Histogram: A graphic representation of the frequency distribution of a continuous

variable. Rectangles are drawn in such a way that their bases lie on a linear scale
representing different intervals, and their heights are proportional to the frequencies of
the values within each of the intervals.

Horizontal survey: A study of a community perhaps stratified by age, sex, ethnicity etc.,
but at one point in time or over a short time interval. Although a snapshot, horizontal
surveys of prevalence and intensity within different age classes of a community can
nevertheless provide valuable information on the rate at which hosts acquire infection
through time, provided that the host and parasite populations have remained
approximately stable for a period of time (i.e. stable endemicity).

Horizontal transmission: Transmission occurring generally within a population, but not

including vertical transmission.

Host: A person or other living organism that can be infected by an infectious agent under
natural conditions.

Host factor: An intrinsic factor (age, race, sex, behaviours, etc.) which influences an
individual's exposure, susceptibility, or response to a causative agent.

Hyperendemic disease: A disease that is constantly present at a high incidence and/or

prevalence rate.

Hypoendemic: A term from the malaria literature used to mean (roughly) an area with
little transmission.

13
Hypothesis: A supposition arrived at from observation or reflection, which leads to
refutable predictions. Any conjecture cast in a form that will allow it to be tested and
refuted.

Hypothesis, null: The first step in testing for statistical significance in which it is
assumed that the exposure is not related to disease.

Hypothesis, alternative: The hypothesis, to be adopted if the null hypothesis proves

implausible, in which exposure is associated with disease.

Informatics: It is the supply of information through the medium of the computer.

Immunity, active: Resistance developed in response to stimulus by an antigen (infecting

agent or vaccine) and usually characterized by the presence of antibody produced by the
host.

Immunity, herd: The resistance of a group to invasion and spread of an infectious agent,
based on the resistance to infection of a high proportion of individual members of the
group. The resistance is a product of the number susceptible and the probability that
those who are susceptible will come into contact with an infected person.

Immunity, passive: Immunity conferred by an antibody produced in another host and

acquired naturally by an infant from its mother or artificially by administration of an
antibody-containing preparation (antiserum or immune globulin).

Immunization: Introducing weakened or killed germs or toxins into the body so that the
immune system will make protective antibodies that will destroy the disease causing
agent (for example, a virus) if it enters the body at a later time.

Immunogenicity: The ability of a vaccine to stimulate the immune system, as measured

by the proportion of individuals who produce specific antibody or T cells, or the amount
of antibody produced.

Incidence density: Incidence density (also called true incidence rate, hazard rate, force
of morbidity or mortality) is defined as the instantaneous potential for change in disease
status per unit of time at time t, relative to the size of the disease-free population at time
t.

Incidence rate: A measure of the frequency with which an event, such as a new case of
illness, occurs in a population over a period of time. The denominator is the population at
risk; the numerator is the number of new cases occurring during a given time period.
Incidence is the number of new cases occurring in a specified period of time and in a
defined population

Incubation period: A period of subclinical or inapparent pathologic changes following

exposure, ending with the onset of symptoms of infectious disease.

14
Independent variable: An exposure, risk factor, or other characteristic being observed
or measured that is hypothesized to influence an event or manifestation (the dependent
variable).

Index case: The first case of a disease or health condition that is known to investigators.
Identifying the index case can be helpful in determining the origin of a disease outbreak.

Indirect transmission: The transmission of an agent carried from a reservoir to a

susceptible host by suspended air particles or by animate (vector) or inanimate (vehicle)
intermediaries.

Individual data: Data that have not been put into a frequency distribution or rank
ordered.

Infection: The presence of a parasite within a host where it may or may not
cause disease.

Infectious period: The time period during which infected are able to transmit an
infection to any susceptible host or vector they contact. Note that the infectious period
may not necessarily be associated with symptoms of the disease.

Infectivity: The ability of an infectious agent to cause infection, measured as the

proportion of persons exposed to a causative agent who become infected by an infectious
disease.

Inference, statistical: In statistics, the development of generalizations from sample data,

usually with calculated degrees of uncertainty.

Information bias: The type of bias can occur when interviewers who are aware of the
identity of subjects or factors of interest (e.g., case or control) and collect information
unevenly between subjects.

Interaction: Two or more component causes acting in the same sufficient cause

Interquartile range: The central portion of a distribution, calculated as the difference

between the third quartile and the first quartile; this range includes about one-half of the
observations in the set, leaving one-quarter of the observations on each side.

Isolation: Limiting movement of or separating people who are ill with a contagious
disease.

Landscape epidemiology : The study of diseases in relation to the ecosystems in which

they are found .

Latency period: A period of subclinical or inapparent pathologic changes following

exposure, ending with the onset of symptoms of chronic disease.

15
Life expectancy: Life expectancy is the average number of years of life remaining to a
person at a particular age and is based on a given set of age-specific death rates, generally
the mortality conditions existing in the period mentioned. Life expectancy may be
determined by race, sex, or other characteristics using age-specific death rates for the
population with that characteristic.

Live birth: A live birth is the complete expulsion or extraction from its mother of a
product of conception, irrespective of the duration of the pregnancy, which, after such
separation, breathes or shows any other evidence of life such as heartbeat, umbilical cord
pulsation, or definite movement of voluntary muscles, whether the umbilical cord has
been cut or the placenta is attached. Each product of such a birth is considered live born.

Line listing: A list, or spreadsheet, of cases containing demographic characteristics and

other key descriptions.

Mass screening: Large—scale screening of whole, unselected population groups.

Measure of association: A quantified relationship between exposure and a particular

health problem.

Mean, arithmetic: The measure of central location commonly called the average. It is
calculated by adding together all the individual values in a group of measurements and
dividing by the number of values in the group.

Mean, geometric: The mean or average of a set of data measured on a logarithmic scale.

Measure of association: A quantified relationship between exposure and disease;

includes relative risk, rate ratio, odds ratio.

Measure of central location: A central value that best represents a distribution of data.
Measures of central location include the mean, median, and mode. Also called the
measure of central tendency.

Measure of dispersion: A measure of the spread of a distribution out from its central
value. Measures of dispersion used in epidemiology include the interquartile range,
variance, and the standard deviation.

Median: The measure of central location which divides a set of data into two equal parts.

Medical surveillance: The monitoring of potentially exposed individuals to detect early

symptoms of disease.

Mesoendemic: It is an endemic disease that affects a moderate proportion of the

population at risk.

Midrange: The halfway point or midpoint in a set of observations. For most types of data,
it is calculated as the sum of the smallest observation and the largest observation, divided

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by two. For age data, one is added to the numerator. The midrange is usually calculated as
an intermediate step in determining other measures.

Misclassification: This type of bias can occur when there is error in classifying subjects
by disease or risk factor that tends to distort associations between disease and risk
factors. The effect of misclassification with respect to exposure or disease is dependent
on the individual’s disease or exposure status. When the misclassification is random or
non-differential, the proportions of subjects erroneously classified in the study groups
are approximately equal. With differential misclassification, the proportions of subjects
classified incorrectly differ between groups.

Mode: A measure of central location, the most frequently occurring value in a set of
observations.

Mode of transmission: The way or ways in which a disease is transmitted. The

transmission can be direct (person-to-person) or indirect.

Molecular epidemiology: A kind of epidemiologic investigation that uses molecular

laboratory techniques to detect outbreaks.

Morbidity: Any departure, subjective or objective, from a state of physiological or

psychological well-being.

Mortality/mortality rate: A measure of the frequency of occurrence of death in a

defined population during a specified interval of time (or) The number of deaths due to a
disease occurring in a specified period of time and in a defined population.

Mortality rate, infant: A ratio expressing the number of deaths among children under
one year of age reported during a given time period divided by the number of births
reported during the same time period. The infant mortality rate is usually expressed per
1,000 live births.

Mortality rate, neonatal: A ratio expressing the number of deaths among children from
birth up to but not including 28 days of age divided by the number of live births reported
during the same time period. The neonatal mortality rate is usually expressed per 1,000
live births.

Mortality rate, postneonatal: A ratio expressing the number of deaths among children
from 28 days up to but not including 1 year of age during a given time period divided by
the number of lives births reported during the same time period. The postneonatal
mortality rate is usually expressed per 1,000 live births.

Natural history of disease: The temporal course of disease from onset (inception) to
resolution.

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Necessary cause: A causal factor whose presence is required for the occurrence of the
effect (of disease).

Negative predictive value: The proportion of those testing negative in a screening test
for a disease who truly do not have the disease.

Nested case-control study: It is similar to a cohort study with the key difference that a
sample of non-cases is selected for analysis (rather than the entire cohort, as in the case
of a cohort study).

Niche: It is the position or function of an organism in a community ofplants and animals.

Nidus: It is a place where something originates, develops, or is located or it is a

place or substance in an animal or plant where bacteria or other organisms lodge
and multiply. It is a focus of infection.

Nominal scale: Classification into unordered qualitative categories; e.g., race, religion,
and country of birth as measurements of individual attributes are purely nominal scales,
as there is no inherent order to their categories.

Nosoarea: A nosoarea is a nosogenic territory in which a particular disease is present.

Nosogenic territory : An area that has ecological, social and environmental conditions
that can support a disease outcome.

Normal curve: A bell-shaped curve that results when a normal distribution is graphed.

Normal distribution: The symmetrical clustering of values around a central location.

The properties of a normal distribution include the following: (1) It is a continuous,
symmetrical distribution; both tails extend to infinity; (2) the arithmetic mean, mode, and
median are identical; and, (3) its shape is completely determined by the mean and
standard deviation.

Numerator: The upper portion of a fraction.

Observational study: Epidemiological study in situations where nature is allowed to

take its course. Changes or differences in one characteristic are studied in relation to
changes or differences in others, without the intervention of the investigator.

Odds ratio: A measure of association which quantifies the relationship between an

exposure and health outcome from a comparative study; also known as the cross-product
ratio.

Ordinal scale: Classification into ordered qualitative categories; e.g., social class (I, II, III,
etc.), where the values have a distinct order, but their categories are qualitative in that
there is no natural (numerical) distance between their positive values.

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Outbreak: Synonymous with epidemic. Sometimes the preferred word, as it may escape
sensationalism associated with the word epidemic. Alternatively, a localized as opposed
to generalized epidemic.

Outbreak investigation: The investigation of the occurrence of a disease in a specific

group of people.

Outlier: In statistics, an observation or value that is significantly different from the rest of
the scores.

Oversample: A sampling procedure designed to give a demographic or geographic

population a larger proportion of representation in the sample than the population's
proportion of representation in the overall population.

p-value: The probability of obtaining a result at least as extreme as a given data point,
assuming the data point was the result of chance alone.

Pathogenicity (or virulence) : Which is the ability of an agent to produce disease in a

range of hosts under a range of environmental conditions.

Panel study: It combines the features of cross-sectional and a prospective cohort designs.
It can be viewed as a series of cross-sectional studies conducted on the same subjects (the
panel) at successive time intervals (sometimes referred to as waves).

Pandemic: An epidemic occurring over a very wide area (several countries or

continents) and usually affecting a large proportion of the population.

Parity: Parity is defined as the total number of live births ever had by the woman. This
number is distinguished from gravidity, which is the total number of times she has been
pregnant. Nulliparous women are those who have had no live births, and parous women
are those who have given birth to at least one baby.

Passive immunity: Immunity conferred by an antibody produced in another host. This

type of immunity can be acquired naturally by an infant from its mother or artificially by
administration of an antibody-containing preparation (antiserum or immune globulin).

Passive surveillance: A provider-based approach to data collection, in which health

departments or the Centers for Disease Control and Prevention (CDC) depend on disease
reports to be submitted by laboratories, clinicians, and the public.

Pathogenicity: The proportion of persons infected, after exposure to a causative agent,

who then develop clinical disease.

Percentile: The set of numbers from 0 to 100 that divide a distribution into 100 parts of
equal area, or divide a set of ranked data into 100 class intervals with each interval
containing 1/100 of the observations. A particular percentile, say the 5th percentile, is a

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cut point with 5 percent of the observations below it and the remaining 95% of the
observations above it.

Period prevalence: The amount a particular disease present in a population over a

period of time.

Person-years: The sum of the lengths of time of experience or exposure of a group of

people who have been observed for varying periods of time, in other words, the total
amount of time, expressed in years, that the entire group been exposed, observed, or at
risk.

Person-time rate: A measure of the incidence rate of an event, e.g., a disease or death, in
a population at risk over an observed period to time, that directly incorporates time into
the denominator.

Pie chart: A circular chart in which the size of each ``slice'' is proportional to the
frequency of each category of a variable.

Point prevalence: The amount of a particular disease present in a population at a single

point in time.

Point source outbreak: An outbreak that results from a exposure to the same source

Population: The total number of inhabitants of a given area or country. In sampling, the
population may refer to the units from which the sample is drawn, not necessarily the
total population of people.

Population attributable risk (rate): It is the increase or decrease in incidence risk (or
rate) of disease in the population that is attributable to exposure.

Population attributable fraction/ aetiologic fraction: It is the proportion of disease

in the population that is due to the exposure.

Population at risk: The total number of inhabitants of a given area who may contract the
disease of interest.

Portal of entry: A pathway into the host that gives an agent access to tissue that will
allow it to multiply or act.

Portal of exit: A pathway by which an agent can leave its host.

Positive predictive value: A measure of the predictive value of a reported case or

epidemic; the proportion of cases reported by a surveillance system or classified by a case
definition which are true cases.

Precision: "Precise" means sharply defined or measured. Data can be very precise, but
inaccurate

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Prepatent period: It refers to the time between infection and when the agent becomes
first detectable, and the period of communicability is the time during which the infected
host is capable of transmitting the agent.

Prevalence: The number or proportion of cases or events or conditions in a given

population. Prevalence is the number of people currently living with a disease, and
provides a useful indication of the number of patients being actively treated for their
disease.

Prevalence rate: The proportion of persons in a population who have a particular

disease or attribute at a specified point in time or over a specified period of time.

Primary case: A person who acquires a disease from an exposure, for example, to
contaminated food.

Program evaluation: The study of the activities and outcomes of a program or project in
order to assess its effectiveness or value.

Propagated outbreak: An outbreak that does not have a common source, but instead
spreads from person to person.

Proportion: A type of ratio in which the numerator is included in the denominator. The
ratio of a part to the whole, expressed as a ``decimal fraction'' (e.g., 0.2), as a fraction
(1/5), or, loosely, as a percentage (20%).

Proportionate mortality: The proportion of deaths in a specified population over a

period of time attributable to different causes. Each cause is expressed as a percentage of
all deaths, and the sum of the causes must add to 100%. These proportions are not
mortality rates, since the denominator is all deaths, not the population in which the
deaths occurred.

Prospective study: At the time a study begins, either the exposure or the outcome of
interest has not yet occurred.

Public health surveillance: The systematic collection, analysis, interpretation, and

dissemination of health data on an ongoing basis, to gain knowledge of the pattern of
disease occurrence and potential in a community, in order to control and prevent disease
in the community.

Quarantine: Limiting movement of or separating people who are not sick but are
presumed to have been exposed to a contagious disease

Questionnaire: A set of questions used to collect information. Typically questions can be

grouped into the following categories: identifying, demographic, clinical, risk, and
reported information.

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R

Race-specific mortality rate: A mortality rate limited to a specified racial group. Both
numerator and denominator are limited to the specified group.

Random sample: A sample derived by selecting individuals such that each individual has
the same probability of selection.

Randomised clinical trials: The randomised clinical trial is the epidemiologic design
that most closely resembles a laboratory experiment

Range: In statistics, the difference between the largest and smallest values in a
distribution. In common use, the span of values from smallest to largest.

Rate: An expression of the frequency with which an event occurs in a defined population.

Rate ratio: A comparison of two groups in terms of incidence rates, person-time rates, or
mortality rates.

Ratio: The value obtained by dividing one quantity by another.

Recall bias: This type of bias can occur in retrospective studies when persons with
disease tend to report past exposures and events differently from persons without
disease.

Relative risk: A comparison of the risk of some health-related event such as disease or
death in two groups.

Reliability: Refers to the consistency of a measurement when repeated on the same

subjects.

Repeated survey: It is a series of cross-sectional studies performed over time on the

same study population, but each is sampled independently.

Representative sample: A sample whose characteristics correspond to those of the

original population or reference population.

Reservoir: The habitat, in which an infectious agent normally lives, grows and multiplies;
reservoirs include human reservoirs, animals’ reservoirs, and environmental reservoirs.

Retrospective study: At the time a study begins, both the exposure and the outcome of
interest have occurred.

Risk: The probability that an event will occur, e.g. that an individual will become ill or die
within a stated period of time or age.

Risk analysis: A process consisting of three components: risk assessment, risk

management and risk communication.

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Risk assessment: A scientifically based process consisting of the following steps: (i)
hazard identification, (ii) hazard characterization, (iii) exposure assessment, and (iv) risk
characterization.

Risk characterization: The process of determining the qualitative and/or quantitative

estimation, including attendant uncertainties, of the probability of occurrence and
severity of known or potential adverse health effects in a given population based on
hazard identification, hazard characterization and exposure assessment.

Risk communication: The interactive exchange of information and opinions concerning

risk and risk management among risk assessors, risk managers, consumers and other
interested parties.

Risk Estimate: Output of risk characterization.

Risk factor: An aspect of personal behaviour or lifestyle, an environmental exposure, or

an inborn or inherited characteristic that is associated with an increased occurrence of
disease or other health-related event or condition.

Risk Management - The process of weighing policy alternatives in the light of the results
of risk assessment and, if required, selecting and implementing appropriate control
options, including regulatory measures.

Risk ratio: A comparison of the risk of some health-related event such as disease or
death in two groups.

Sample: A selected subset of a population. A sample may be random or non-random and

it may be representative or non-representative.

Sample size: The size of the group being studied. “N” is used to indicate the sample size;
for example, if you have a sample of 34 people, n=34.

Screening: The presumptive identification of unrecognized disease or defect by the

application of tests, examinations, or other procedures which can be applied rapidly.

Scatter diagram: A graph in which each dot represents paired values for two continuous
variables, with the x-axis representing one variable and the y-axis representing the other;
used to display the relationship between the two variables; also called a scattergram.

Seasonality: Change in physiological status or in disease occurrence that conforms to a

regular seasonal pattern.

Secondary attack rate: A measure of the frequency of new cases of a disease among the
contacts of known cases.

Secondary case: A person who gets a disease from exposure to a person with the disease,
or primary case.

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Secular trend: Changes over a long period of time, generally years or decades.

Selective screening: Screening of selected high-risk groups in the population.

Sensitivity: The ability of a system to detect epidemics and other changes in disease
occurrence. The proportion of persons with disease who are correctly identified by a
screening test or case definition as having disease.

Sentinel surveillance: A surveillance system in which a pre-arranged sample of

reporting sources agrees to report all cases of one or more notifiable conditions or
diseases.

Shifting antigenicity: The condition when an infection-causing organism’s antibody

producing characteristics change greatly, which usually causes immunity to the infection
to decrease significantly.

Sex-specific mortality rate: A mortality rate among either males or females.

Significance test: A test of statistical significance shows how likely one is to get a
measure of association as strong as the observed one if there is no difference between the
groups.

Skewed: A distribution that is asymmetrical.

Specificity: The proportion of persons without disease who are correctly identified by a
screening test or case definition as not having disease.

Sporadic: A disease that occurs infrequently and irregularly.

Spot map: A map that indicates the location of each case of a rare disease or outbreak by
a place that is potentially relevant to the health event being investigated, such as where
each case lived or worked.

Standard deviation: The most widely used measure of dispersion of a frequency

distribution, equal to the positive square root of the variance.

Standard error (of the mean): The standard deviation of a theoretical distribution of
sample means about the true population mean.

Standard population: A population used to allow comparisons over time and among
different parts of the population. By convention in the US, the standard population is the
US population in the year 2000.

Statistical significance: The degree to which a value is greater or smaller than would be
expected to occur by chance. Typically, a relationship is considered statistically significant
when the probability of obtaining that result by chance is less than five per cent if there
were, in fact, no relationship in the population being studied.

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Study design: The methodology that is used to investigate a particular health
phenomenon or exposure-disease relationship. Studies can be descriptive or analytical.

Study Population: The population of specific interest, e.g. New Delhi female dog
population.

Subclinical: Without apparent symptoms

Sufficient cause: A causal factor or collection of factors whose presence is always

followed by the occurrence of the effect (of disease).

Superspreader: An individual who is much more infective than most other people with
the disease.

Surveillance: The collection of information on cases of disease or other conditions in a

standard way to detect increases or decreases in the disease over time and differences
between various geographic areas. Public health officials use the information to detect
outbreaks and to plan programs to help prevent and control disease.

Survival: The proportion of individuals diagnosed with a specific disease surviving over a
defined period of time.

Survival curve: A curve that starts at 100% of the study population and shows the
percentage of the population still surviving at successive times for as long as information
is available. May be applied not only to survival as such, but also to the persistence of
freedom from a disease, or complication or some other endpoint.

Symptom: Any indication of disease noticed or felt by a patient

Syndromic surveillance: The collection and analysis of pre-diagnosis information that

lead to an estimation of the health status of the community. In other words it is
monitoring of non-specific health indicators including clinical signs, symptoms or proxy
measures to enable the early identification of the impact (or absence of impact) of
potential human or veterinary public health threats.

Synanthropic ecosystem: Synanthropic ecosystem is one that is in contact with

man. This facilitates transmission of zoonotic infections.

Table: A set of data arranged in rows and columns.

Table shell: A table that is complete except for the data.

Targeted intervention: A program or activity intended to improve a health condition

among a specific group of people.

25
Theory: An explanation accounting for known facts or phenomena, capable of predicting
future occurrences or observations of the same kind, and capable of being tested through
experiment or proven false through empirical observation.

Transmission of infection: Any mode or mechanism by which an infectious agent is

spread through the environment or to another person.

Trend: A long-term movement or change in frequency, usually upwards or downwards.

Type I Errors/Alpha error/ False positive: Type I errors occur when the null
hypothesis is rejected when it is true.

Type II errors/Beta error/False Negative: Type II errors occur when the null
hypothesis is accepted when it is false.

Two-by-two table: A table with only two variables, in which each variable has only two
categories. Usually one variable represents a health outcome, and one represents an
exposure or characteristic.

Universal precautions: Recommendations issued by CDC to minimize the risk of

transmission of bloodborne pathogens, particularly HIV and HBV, by health care and
public safety workers. Barrier precautions are to be used to prevent exposure to blood
and certain body fluids of all patients.

Vaccine efficacy: It stands for the proportion of disease prevented by the vaccine in
vaccinated animals. Vaccine efficacy is estimated through subtracting cumulative
incidence in vaccinated animals from cumulative incidence in unvaccinated animals, and
dividing the resulting value by the cumulative incidence in unvaccinated animals.

Validity: The degree to which a measurement actually measures or detects what it is

supposed to measure.

Variable: Any characteristic or attribute that can be measured.

Variance: A measure of the dispersion shown by a set of observations, defined by the

sum of the squares of deviations from the mean, divided by the number of degrees of
freedom in the set of observations.

Vector: An animate intermediary in the indirect transmission of an agent that carries the
agent from a reservoir to a susceptible host.

Vehicle: An inanimate intermediary in the indirect transmission of an agent that carries

the agent from a reservoir to a susceptible host.

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 Vehicular transmission: It refers to transfer of the agent in inanimate substances
(fomite).

Virulence: The proportion of persons with clinical disease, who after becoming infected,
become severely ill or die.

Vital statistics: Systematically tabulated information about births, marriages, divorces,

and deaths, based on registration of these vital events.

Years of potential life lost: A measure of the impact of premature mortality on a

population, calculated as the sum of the differences between some predetermined
minimum or desired life span and the age of death for individuals who died earlier than
that predetermined age.

Zoonoses: An infectious disease that is transmissible under normal conditions from

animals to humans.

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