This document defines and distinguishes between endemic, epidemic, and pandemic diseases. Endemic diseases occur at low levels in a population. Epidemics occur in large numbers over a specific area. Pandemics spread over several large areas worldwide, such as the Spanish flu or bubonic plague. The document provides examples of diseases that fall into each category and instructs students to classify infectious disease scenarios.

1. HLT 220 Concepts of Disease

2.  Distinguish between the terms endemic,
epidemic and pandemic by identifying the key
characteristics of each in a multiple choice
question(s)
 Given a list of infectious disease scenarios,
classify (sort) the diseases as endemic,
epidemic, or pandemic

3.  Term used to describe a disease that always
(generally) occurs in low levels in a population
 Examples
 Malaria
 Sexually Transmitted Diseases (STDs)

4. Map image obtained from http://facts.kff.org

5.  STDs on residential college campuses
Image acquired from www.yukonlawfoundation.com

6.  Term used to describe a disease that occurs in
unusually large numbers over a specific area
. . . Outbreak

7. Footnote: The transition from endemic to epidemic can happen in days, weeks, months or even years
depending on the disease.
Image acquired from www.dhss.mo.gov/EPI/endemicvsepidemic.html

8.  Age
 Geography
 STDs on residential college campuses
Image acquired from www.yukonlawfoundation.com

9. Image acquired from www.yukonlawfoundation.com

10.  Term used to describe a disease that occurs in
unusually large numbers over a specific area
 Examples
 One STD on one college campus
 Food-borne illnesses (Hepatitis A, salmonella)
 SARS in Asia, MRSA, Highly resistant TB
 In the early US, infection of Native Americans with
Smallpox, measles, influenza
 Two more . . .

11. Graph acquired from www.waterandhealth.org

12.  Water supply in
Milwaukee, 1993
 400K infected, over
100 deaths
 Worst parasitic
outbreak in US
history
http://animal.discovery.com/videos/monsters-inside-me-cryptosporidium-
outbreak.html
Image obtained from http://animal.discovery.com

13. Obesity Trends* Among U.S. Adults
BRFSS, 1990, 1999, 2009
(*BMI 30, or about 30 lbs. overweight for 5’4” person)
1990 1999
2009
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Graph obtained from www.cdc.gov/obesity/data/trends.html

14.  Term used to describe an epidemic that has
spread to include several large areas worldwide
 Examples
 Spanish Flu of 1918
 Bubonic Plague or “Black Death” (1300s & 1600s)
 One current pandemic??

15.  “According to world
experts, pandemic
plague is inevitable.
There were major
episodes in 1348 and
1665: another is
overdue and could
happen at any time.” –
Fitzpatrick, 2007
Image obtained search of Bubonic Plague from http://search.creativecommons.org

16.  Endemic  In US, initially
impacted gay men, IV
drug users and those
 Epidemic requiring blood
transfusions
 Greater population
(heterosexuals, particul
arly females, AIDS over
 Pandemic 50)

17. Map obtained from www.unaids.org, 2008 report on the global AIDS epidemic

18.  Distinguish between the terms endemic,
epidemic and pandemic by identifying the key
characteristics of each in a multiple choice
question(s)
 Given a list of infectious diseases, classify
(sort) the diseases as endemic, epidemic, or
pandemic

19.  Centers for Disease Control. (2009). US obesity trends, Trends by state, 1985-
2009. Obtained from http://www.cdc.gov/obesity/data/trends.html
 Fitzpatrick, M. (2007). Pandemic plague contingency plan. British Journal of
General Practice, 57(534). Obtained from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2032711/.
 Billings, Molly (2005). The Influenza Pandemic of 1918. Obtained from
http://virus.stanford.edu/uda/.
 UN AIDS. (2008). 2008 Report on the Global AIDS Epidemic. Obtained from
http://www.unaids.org/en/KnowledgeCentre/HIVData/GlobalReport/2008/2008_
Global_report.asp.
 Zelman, M., Tompary, E., Raymond, J., Holdaway, P. & Mulvihill, M. L. (2010).
Human Diseases (7th edition). Pearson Publishers: Saddle River, New Jersey.

20.  Infectious disease precautions image (title page) acquired from
http://search.creativecommons.org/
 College couple image acquired from www.yukonlawfoundation.com
 Endemic versus epidemic graph acquired from Image acquired from
www.dhss.mo.gov/EPI/endemicvsepidemic.html
 US obesity trends map, 1985-2009. Obtained from
http://www.cdc.gov/obesity/data/trends.html
 Endemic malaria map obtained from http://facts.kff.org
 Elder couple images acquired from http://eldercarehomefinder.com/ and
http://www.lakewoodhomecare.com/
 Images from Outbreak acquired from http://tech.mit.edu/V115/N14/ots.14a.html and
http://www.flmboynt.com/2010/08/just-be-tv-films-5/
 Waterborne illness map acquired from
http://www.waterandhealth.org/newsletter/new/spring_2003/waterborne.html
 A global view of HIV infection map acquired from
http://www.unaids.org/en/KnowledgeCentre/HIVData/GlobalReport/2008/2008_Glob
al_report.asp.
 Bubonic Plague image from http://search.creativecommons.org