1.1 Introduction
Pandemics and global outbreaks have always been a threat to not only mankind but also the wildlife risking their population to get endangered. Pandemics have stopped human life numerous times and have struck the world hard a number of times and claimed many human lives.
As indicated by the Centers for Disease Control and Prevention (CDC)āa public general well-being establishment in the United StatesāāEpidemiology is the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the control of health problemsā [1].
Since a lot of news has emerged recently regarding dengue, Zika virus (2016), H1N1 (2009), SARS, Hanta virus, and most recently COVID-19 (2019), it has become more significant to understand the difference between the epidemiological terms such as epidemic, endemic, pandemic, and outbreak. Spanish flu, common cold, SARS, MERS, and H1N1 are few of the viruses that have been able to invade the human population and claim a number of lives. We have yet again been in the hard times of facing the difficult situation of fighting the battle against another global pandemic, COVID-19. As per the weekly epidemiological update published by the World Health Organization (WHO), more than 53.1 million people have been affected by the infectious coronavirus disease. The virus has killed more than 1.3 million humans since the start of the pandemic until November 14, 2020. Not only does the battle stop at preventing ourself from getting infected but also to be able to invent and discover a vaccine or treatment against the virus in the soonest of time.
At the time of writing, we are almost 11 months into 2020 and the world is struggling with this existential global crisis. The WHO called the COVID-19 viral disease a pandemic. The governments across the world advised their people to follow safety guidelines in order to help prevent the spread of the virus. Being a contagious and a touch-invoked infection, the virus can quickly capture a host just by sitting next to or by talking to an infected person from a short distance. The epicenter of this global outbreak was learned to be at Wuhan, China, and a strategy was formed to contain the spread on an epidemic level. The range of virus being widespread and impacts being dangerous, the virus crossed country borders and was declared as a pandemic. The world is experiencing difficulties and is also following the precaution guidelines and staying safe.
1.2 Pandemic and Epidemic: An Overview
An epidemic is named a circumstance wherein an infection is spreading actively. Epidemic can be termed or defined as a phenomenon where thousands of people in a region are infected by a deadly infection or virus. As against this, the term pandemic identifies with geographic spread and is utilized as a phrasing to depict an infection which has influenced an entire nation or the total globe. A global epidemic is termed as a pandemic. It is a plague that has spread its wings more than a few nations or landmasses of the globe influencing countless individuals. At the point when the quantity of cases surpasses more than what might be normal, it is named an epidemic, in epidemiologic terms, similar to the COVID-19. If there is an outbreak that affects most of the world, it is referred to as a pandemic. It generally describes an unexpected increase in the number of infected people. An outbreak can occur in a particular community, geographical region, or several countries at the same time.
The term endemic is used when there is a disease that exists ceaselessly inside a geographic area. Endemic contamination is about infections, microscopic organisms, and microorganisms that exist inside a particular area topographically. While informal use of the term epidemic may not require such distinction, itās critical to be able to differentiate between the two terms (and some identical ones like endemic and outbreak) when dealing with news related to public health.
Epidemiological terms that would be used in this book are
Outbreak: It is used if the number of infections exceeds more than what would be expected
Endemic: A contamination/infection within a geographic area that is existing continually.
Epidemic: A situation when a disease is spreading actively.
Pandemic: A global endemic
1.2.1 Endemic
The term endemic refers to a sickness, infection, or well-being worry that is continually present in a given area or populace inside a geographic district. The quantity of affected people is low and doesnāt essentially increase or reduce after some time; For example, chicken pox, which influences kids at sporadic unsurprising rate in the UK and jungle fever or malaria, which is continually present in numerous places of Africa. In the event that we think about the case of dengue fever, there are numerous parts on the planet where dengue fever has been proclaimed as an endemic by WHO, which implies that there are mosquitoes existing in these regions that are transmitting the dengue fever and communicating it from individual to individual. In any case, imported cases and imported flare-ups of dengue are additionally found in various regions where this infection is definitely not an endemic. Recently in 2015ā2016, there was a flare-up in the Big Island of Hawaii where somebody, probably came in affected with dengue fever, got bit by mosquitoes, and subsequently there was a local chain of transmissions where those mosquitoes then bit others, they got dengue fever, and so on. For this circumstance, dengue fever isnāt endemic in the Big Island; however, there was an outbreak because of an imported infection with resulting transmission.
1.2.2 Epidemic
Thucydides, an Athenian officer in B.C. times described Plague of Athens to be an earliest occurrence of an epidemic disease. Until the 17th century, endemic and epidemic were two terms, which were considered to depict contrasting conditions of diseases based on the level of population being affected. Endemic depicted a condition at low rates of occurrence and the epidemic was considered as a widespread condition. Any problem that grows out of control or extends beyond an intended population is termed as an epidemic. Some previous examples of such epidemic problems are the 1918 Spanish flu, measles outbreak, and 2014ās whooping cough.
Atlantaās Center for Disease Control [2] describes an epidemic as
the occurrence of more cases of the disease, injury, or other health condition than expected in a given area or among a specific group of persons during a particular period. Usually, the cases are presumed to have a common cause or to be related to one another in some way.
An epidemic holds a reputation of spreading rapidly in a contained area, e.g., the seasonal flu, which sometimes is referred to as an endemic, behaves more like an epidemic because cases spike at a certain time of the year. Some classical epidemics in history include the yellow fever which killed 5,000 people in Philadelphia in 1793 and Cholera in the United States which killed over 1,50,000 Americans in three waves. It is still prevalent and fatal in many parts of the world.
An epidemic disease may or may not be infectious. WHO has used the term for both the West Nile fever, which is infectious, and to obesity, which is noninfectious.
The two significant conditions which lead to the flare-up of epidemics may include movement of populations of certain animals, such as rats or mosquitoes, which may act as illness transporters and the supply of infected food such as contaminated drinking water.
There are a few epidemics which may be governed by certain seasons. For instance, people suffer from whooping cough during springs, while measles results in two epidemics, one in March and the other one in winter. Flu, common cold, and different diseases of the upper respiratory tract, for example, sore throat, occur predominatingly in the winter.
There is another variety of epidemic, both with respect to the quantity of individuals being influenced by the epidemic and the quantity of individuals who die in successive epidemics, common source outbreak, and propagated outbreak.
Common source outbreak: The affected individuals had an exposure to a common transmitter in a common source outbreak epidemic. On the contrary, if the exposure is singular and all of the affected people develop the disease as a result of exposure to a single source and incubation course, it very well may be named a point source outbreak, but if the exposure is nonstop or variable, it can be termed an intermittent or continuous outbreak.
Propagated outbreak: The disease spreads person-to-person in a propagated outbreak, and the individuals who are affected may become independent reservoirs which may lead to further exposures. At most of the times, epidemics will display characteristics of both common source and propagated outbreaks, which are very often referred to as a mixed outbreak.
1.2.3 Pandemic
An epidemic becomes a pandemic when it affects a large percent of the population, crosses national and international boundaries, and, most of the times, affects people on a global scale. Essentially, a pandemic is not limited to a specific geography or population. It usually affects a significant number of people across countries and continents. In short, pandemic is an upgrade of epidemic at an international or massive population level. A disease or a medical condition cannot be termed as a pandemic just because it has spread over a large area or it has killed numerous people, but it must be infectious too. As an example, cancer is responsible for claiming thousands of lives, but it is not regarded as a pandemic because the disease is neither contagious nor infectious.
The most prolific pandemics from history include the HIV/AIDS that has claimed the lives of more than 36 million people since 1981, and over 35 million cases are still prevalent in the world: the Spanish flu in 1918, which infected a population of 500 million, with an estimated mortality of 10%ā20% and the bubonic plague, which spread across Europe, Asia, and Africa, killing an estimated 75ā200 million people, to name a few.
Pandemic can be distinguished from the rest of the epidemiological terms due to the following reasons: