Segregation of epidemiology into chronic and infectious diseases has led to a neglected area in public health – the interface between chronic disease and infectious disease.Choi, B. C., Morrison, H., Wong, T., Wu, J., & Yan, Y. P. (2007). Bringing chronic disease epidemiology and infectious disease epidemiology back together. Journal of Epidemiology & Community Health, 61(9), 802-802.
In the past month or so I’ve been seeing a lot of dialogue on #epitwitter about the lack of infectious disease training in many epidemiology programs. In an informal poll of 1000+ it seemed like many in epidemiology programs don’t receive little to no infectious disease training as part of their core training. The name ‘epidemiology’ calls back the era at the founding of the field when infectious diseases were the main health ‘epidemics’ impacting the population at large. But increasingly, infectious diseases have become a relic of a bygone era, as by far most epidemiologist are focused on chronic diseases.
However, we’ve seen in recent decades many infectious diseases not only interact with chronic diseases, but are the underlying causes of chronic diseases. Infectious disease epidemiologists in many ways continue to be at the forefront of epidemiology, integrating some of the most cutting edge tools into their field: predictive modelling and forecasting, complex spatial analysis, genomic mapping etc. As Choi et al. (2007) describe elegantly, many tools developed by infectious disease researchers may be of utility to understand ‘infectiousness’ in other fields in absence bacterial or viral agents.
Fortunately in absence of structured programs, there are a lot of good resources out there. For example, to be able to conduct my research on tuberculosis (TB) transmission, I had to self-teach a lot of infectious disease epidemiology through text-books, online resources, etc. Below I’ve listed ten courses for self-teaching at the introductory level, all freely available online.
Open courses in infectious disease epidemiology1
Epidemics in Western Society Since 1600 (Yale)
A well-rounded understanding of epidemiology requires a dive into the past. After all, many of the infectious diseases prevalent in the world today, such as tuberculosis, have been with us historically– and as look to eradicate these diseases– those who don’t remember the past, as they say, are doomed to repeat it. This course, offered from a historian’s perspective, covers history stretching from the plague and the social reactions to it, the development of the sanitary movement and germ theory, historical impact of infectious diseases (such as TB, malaria, polio) and re-emergence of these diseases in the modern context. Course recordings from 2010 and sample mid-term and final exams are provided.2
John Snow and the Cholera Epidemic of 1854 (Harvard University via edX)
This course focuses on the a pivotal point in the history of infectious disease epidemiology: the Cholera epidemic of 1854 that swept through London. The course explores the role of one of the legendary figures of epidemiology, John Snow, in understanding how cholera was being spread and how it could be stopped. John Snow’s endeavor is perhaps the most well-known example of what is called ‘shoe-leather epidemiology’, going into the field with your feet to investigate what is happening. John Snow knocked on doors and created maps, and this course includes interactive mapping tools and timelines that allow students to engage with his investigation as it unfolded.3
Epidemiology of Infectious Diseases
This is a comprehensive course in infectious disease epidemiology, covering the basics of the field including definitions, the principles of disease surveillance and outbreak investigation, and types of epidemiologic studies used to investigate outbreaks. The course also includes information about transmission dynamics, technical presentations on modelling and molecular epidemiology which many other courses in this list don’t cover quite as well. Although this is a comprehensive offering, one drawback is that the course is from 2006 and may not include the most up to date information. Nevertheless, highly recommend this for any students in epidemiology looking to extend their training.4
Outbreaks and Epidemics (Johns Hopkins University via Coursera)
This short course takes a more hands-on approach to epidemic dynamics. Over the course of four modules, students are challenged to apply epidemiological and statistical concepts to infectious disease problems. The course examines concepts such as risk difference and relative difference, attack rates, reproductive numbers and other important metric useful in understanding scale of epidemics. Finally, the course applies these concepts to not just infectious disease outbreaks worldwide as many other courses, but to non-infectious disease epidemics such as the opioid epidemic in the US.5
Epidemics – the Dynamics of Infectious Diseases (Penn State University via Coursera)
Over eight modules, this course provides a detailed review of the dynamics of infectious diseases from how they emerge to how they spread through environmental and social networks including concepts such as breaking transmission chains and ‘super-spreaders’. The basic ecology of infectious diseases, including vector-pathogen interaction and how the characteristics of these agents impacts the patterns of disease incidence is examined. The course uses case studies of pandemic influenza, childhood diseases such as measles and malaria as case studies. Finally, the course touches on drug resistance and how it impacts efforts to contain many re-emerging infectious diseases.6
Epidemics, Pandemics and Outbreaks (University of Pittsburgh via Coursera)
While we often think of infectious diseases at the smallest scale—the level of the patient. However, infectious diseases do not recognize borders, and much of how infectious diseases can spread into pandemics is driven by policies at the global, national and local levels. The strength of this course is its focus on policy—how legal and public health systems respond to outbreaks and pandemics. One of the modules on local countermeasures includes extensive discussion ethical and pragmatic issues around disease reporting, travel restrictions, quarantine. Another module focuses on global health security. examining how globalization has altered the patterns of disease transmission, and how nations work together (or not) to detect and respond to infectious disease threats.7
Principles of Infectious Disease Epidemiology Online Training Course (Missouri Department of Health)
For those interested in outbreak investigation, this course developed by the Missouri Department of Health has a fantastic series of modules on the topic. The course covers public health surveillance, including how to evaluate and improve surveillance systems. Then it dives deep into understanding and organizing and interpreting epidemiologic data generated from surveillance and investigation systems. Finally, the course dives into the principles of outbreak investigation—including interviewing skills, preparing investigation reports, with each step taught working through outbreak case studies. To access the course you need to register on the site, but the course is open to public and a great learning experience.8
These two courses examine infectious disease epidemiology in a comprehensive manner. Offered by the University of Hong Kong, the courses have a special focus on infectious diseases in the East Asian context. The first course starts by examining the ecology and evolution of infectious disease, moving on to diseases such as Ebola and Zika and how epidemics emerge. Finally using SARS as a model, the first course evaluates identification of novel diseases, and the use of informatics including genetic data to understand the trajectories of epidemics. The second course elaborates and expands on some of these discussions, with a strong module on infectious disease modeling, examining dynamic and structural uncertainty in models of disease spread. The course also includes a supplemental module on COVID-19, as the course designers are involved in active research in this disease. This module will include “study results, final size estimation for super-spreading clusters, the Chinese experience for global preparedness, and more.”9
Plagues, Pestilence and Pandemics: Are You Ready? (Griffith University via Futurelearn)
This very short course is a useful non-technical review of some of the current and emerging global health pandemics (including SARS and Ebola). The course examines outbreak responses and how transmission chains can be broken. The course also explores bacterial resistance, including healthcare associated infections and the threat they present.10
Lessons from Ebola: Preventing the Next Pandemic (Harvard University via edX)
Ebola virus disease (EBV), a hemorrhagic fever with mortality rates ranging between 20-90%, was first identified in 1976. The disease re-appeared throughout the next four decades in small clusters. However, in 2014 the WHO declared a major outbreak in Guinea which over the course of the following year expanded to many neighboring countries across West Africa. While that outbreak subsided, newer Ebola outbreaks have appearing in the intervening years and as of last year the WHO has declared Ebola a global health emergency. This course takes a retrospective examination of the 2014 Ebola outbreak, focusing on the many aspects of the disease including the presentation and transmission patterns. As well the course examines the numerous challenges that surfaced in containment efforts at the local level, and failure of international efforts to prevent the spread of the disease. The deep dive into this pandemic provides insight into what went wrong, and how we could avoid the same pitfalls in the future.
Additional: live courses focused on ongoing corona virus pandemic (COVID 19)*
COVID-19: Tackling the Novel Coronavirus (The London School of Hygiene & Tropical Medicine via Futurelearn)
In December of 2019, the WHO was informed about a small cluster of cases of pneumonia of unknown origin in Wuhan, China. In the two months following, the disease agent was identified as a new coronavirus (COVID-19) and rapidly spread across the world, infecting hundreds of thousands in a matter of weeks and declared as a worldwide pandemic. At the moment of writing this summary (3/20/2020) this pandemic has lead to states of emergency across many countries, travel bans, and shut down of non-essential services. This course, starting on Mar 23, 2020 will offer the latest information about COVID-19 presented by experts in the field, including the spread mechanisms for the disease the public health measures necessary to contain it.*
Science Matters: Let’s Talk About COVID-19 (Imperial College London via Coursera)
This course (starting on March 19, 2020) is a more in-depth review of COVID-19 covering topics including the basic reproduction number of the disease, its case fatality, phylogenetic analysis, and clinical presentation. The course also offers a review of the economics and social impact of the current outbreak, with the latest materials as events unfold. Finally, the development of a vaccine is the target goal for any new disease, and COVID-19 is no different. this course contains module on the process of vaccine development during real-time epidemics.
If you have suggestions for additional resources, please comment below or email me!
Last updated: 3/21/2020