DANYLO HALYTSKIY LVIV NATIONAL MEDICAL UNIVERSITY DEPARTMENT OF

APPROVED The first Vice-Rector on scientific and pedagogical work Corresponding Member of the Academy of Medical Sciences of Ukraine Professor M.R. Gzhegotsky ______

STUDY PROGRAM "EPIDEMIOLOGY and BIOSAFETY"

for the Vth year foreign students of the Medical Faculty specialties "Medicine" – 7.12010001, "Pediatrics" – 7.12010002

Approved Approved at Methodic meeting at Methodic Commission of Department on methodic commission "23" April 2019 of Preventive Medicine ( № 11) "24" April 2019 Chief of Department (protocol № 3) Professor N.O. Vynograd Committee Chairman ______Professor V.I. Fedorenko ______

LVIV - 2019 2 Programme prepared teachers of Epidemiology department at Danylo Halytskiy Lviv National Medical University: Chief of Department, MDS, Professor N.O. Vynograd, PhD, Assistant Professor Z.P. Vasylyshyn, PhD, Assistant Professor L.P. Kozak, PhD, Assistant Shul U.A., PhD.

The syllabus was discussed and approved at a Meeting of the Epidemiology Department on April “23”, 2019 (Protocol № 11) and Meeting of Preventive Medicine cycle methodical commission on April “24”, 2019 (Protocol № 3). Reviewers: A Chief of Microbiology, Virology and Immunology Department, MDS, Professor O.P. Korniychuk, Assistant Professor of Hygiene and Preventive Toxicology Department, PhD, U.B. Lototska.

Changes and additions to the Study Program for the discipline “Epidemiology and Biosafety” for students of the 5th year of Medical Faculty of specialties "Medicine" - 7.12010001, "Pediatrics" - 7.12010002 for the 2019-2020 academic year

Date and № of the № Content of changes (additions) Note department meeting Protocol 1 The list of Methodological support is 23 April 2019, № 11 added 2 The list of Basic literature has been 23 April 2019, № 11 modified and supplemented 3 The list of Additionally literature has 23 April 2019, № 11 been modified and supplemented

The Chief of the Department of Epidemiology, DMS, M.D., Prof. N.O. Vynograd Changes to the Study Program: - approved at the methodological meeting of the department on April 23, 2019; - approved by the Cyclical Methodological Commission on Preventive Medicine on April 24, 2019.

The list of Methodological support is added: 1. The algorithm of putting on and removing a personnel protective equipment 2. The algorithm of hands hygiene of medical staff. 3. Preventive vaccination recommended by World Health Organization

The list of Basic literature has been modified and supplemented: Bryan Kestenbaum Epidemiology and : An Introduction to 2nd ed. 2019, 292 p. Antonisamy B., Prasanna S. Premkumar, Christopher S. Principles and Practice of Biostatistics, Publisher: Elsevier India. 2017, 390 p. Krieger N. Epidemiology and the People's Health: Theory and Context. Oxford University Press; 1 edition, 2014, 400 p. 1. Smith Th. J., Kriebel D. A. Biologic Approach to Environmental Assessment and Epidemiology. Oxford University Press, 2010 2. Giesecke J. Modern Infectious Epidemiology. ISBN-10: 1444180029, CRC Press; 3 edition, 2017, 481 p. Hamborsky J., Kroger A. Epidemiology and Prevention of Vaccine-Preventable The Pink Book: Course Textbook - 13th Edition, 2015, 375 p. 3. Kobeissy F., Alawieh A., Wang K. et al. Leveraging Biomedical and Healthcare Data. Semantics, Analytics and Knowledge, Elsevier Inc. 2019, 225 p. https://doi.org/10.1016/C2015-0-06232-3 4. Maurice J. M., Davey Sh. State of the World's Vaccines and Immunization: 2009. World Health Organization, 2009. 5. Bloomfield S. et al. The infection risks associated with clothing and household linens in home and everyday life settings, and the role of laundry. International Scientific Forum on Home Hygiene, 2013. https://www.ifh-homehygiene.org › sites › default › files › publications 6. Last J.M. A Dictionary of Epidemiology. Oxford University Press: NY, 2001. http:/www.oup-usa.org. 7. Battin M.P., Francis L.P., Smith Ch.B. The Patient as Victim and Vector: Ethics and Infectious Disease. Oxford University Press: NY, 2009 8. Nelson K.E., Williams C.M. Infectious Disease Epidemiology. Theory and practice. 2d Edition. Jones and Bartlett Publishers, Sudbury Massachusetts, 2004 9. Brownson C. Applied epidemiology: theory to practice. Oxford University Press, 2006 10.Plotkin S.A., Orenstein W.A., Offit P.A. Vaccines. Elsevier Health Sciences, 2008. 11.Brownson C. Applied epidemiology: theory to practice. Oxford University Press, 2006. 12.Murray Ch. J. L., Lopez A. D., Mathers C. D. The global epidemiology of infectious diseases [electronic resource] - wholibdoc.who.int/.../2004/9241592303.pd 13.Infectious Disease Epidemiology Manual – www.biotech.law.lsu.edu/PH/ 14.Murray Ch. J. L., Lopez A. D., Mathers C. D. The global epidemiology of infectious diseases [electronic resource] – wholibdoc.who.int/.../2004/9241592303.p. 15. Cobo F. Imported Infectious Diseases 1st Edition. Woodhead Publishing, 2014, 240 p. https://doi.org/10.1533/9781908818737.9 16.Stella R. Quah International Encyclopedia of Public Health (Second Edition), 2017, 4470 p. https://doi.org/10.1016/B978-0-12-803678-5.00416-1 17.Hersi M, Stevens A, Quach P, Hamel C et al. Effectiveness of Personal Protective Equipment for Healthcare Workers Caring for Patients with Filovirus Disease: A Rapid Review. PLoS ONE. 2015;10(10):e0140290.

The list of Additionally literature has been modified and supplemented: 1. World Health Organization - http://www.who.int 2. National Library of Medicine – http:/www.nlm.nih.gov 3. World Wide Web Virtual Library – Epidemiology http://chanane.ucsf.edu/epidem/epidem.html 4. Archive Epidemiology and Infection - www.ncbi.nlm.nih.gov/pmc/journals 5. Behavioral Risk Factor Surveillance System https://www.cdc.gov/brfss/ 6. Global action plan on antimicrobial resistance https://www.who.int/antimicrobial- resistance/publications/global-action- plan/en/ 7. Health Technical Memorandum 01-04: Decontamination of linen for health and social care http:// www.gov.uk/government/collections/ health-building-notes- core-elements 8. Infection Control in Health Care Facilities https://www.cdc.gov/flu/professionals/infectioncontrol/ 9. Immunization Managers https://www.cdc.gov/vaccines/imz-managers/ 5 EXPLANATORY NOTE

Syllabus prepared on the basis of the Order Danylo Halytskiy LNMU from 04.24.2015. "On the introduction of the new curriculum undergraduate training in the field of "Medicine", "Pediatrics", "Medical-preventive". According to the curriculum for the 5th year medical faculty study course "Epidemiology and biosafety" given 60 hours, including 10 hours of lectures and 30 hours of practical classes and 20 hours of independent (extracurricular) of students. Teaching course is based on the integration of interdisciplinary curricula with such departments as the Department of Biology, Microbiology, General Hygiene and Ecology, Infectious and childhood infectious diseases, Social Hygiene with Health Organization and others. In the thematic plan of lectures and workshops included general questions, special epidemiology, biosecurity and military epidemiology. Of the total epidemiology study provides basic patterns and displays of epidemic process, modern means of prevention of infectious diseases and methods of their use of anti-epidemic measures in the foci of infectious diseases, epidemiological methods of diagnosis. In workshops with special epidemiology and biosafety students by solving situational problems, study features epidemiological survey and conducting countermeasures in the foci of respiratory tract infections (diphtheria, measles, meningococcal disease, influenza), intestinal infections (shigellosis, hepatitis A, typhoid fever and paratyphoids) with transmissible infections (Lyme borreliosis) and contact mechanisms (hepatitis B and C, HIV), especially dangerous infections. The module involves mastering the necessary knowledge on issues of biosafety and the organization of preventive and countermeasures in emergency situations in peacetime, including the conditions of entry quarantine infections. In studying the material submitted for testing work, students are given advice to the lecturer. The volume and quality of learning is controlled during the current training at workshops according to specific objectives (oral examination, solving situation tasks, tests). Final control module based on lectures, practical (classroom) and self-employment (extracurricular) work carried out on its completion in the form of competition. Assessment of students with discipline is set as the arithmetic mean score for the traditional 4-point scale assimilation of relevant thematic modules and transferred by multi-scale and should determine the ECTS system and the traditional scale accepted in Ukraine. 6 DESCRIPTION OF EDUCATIONAL DISCIPLINE

For foreign students of medical faculty specialties 7.12010001– "Medicine", 7.12010002 – "Pediatrics", qualification - Phisician

The number of credits, hours Structure of the Auditorium Academic Type of Self- course Total Lectures Practical year, term control studies classes "Epidemiology Test/ 2 10 30 20 IX-X and Biosafety" Credit

PURPOSE OF THE DISCIPLINE

The purpose of discipline "Epidemiology and Biosafety":  Training of specialists who have the necessary amount of theoretical and practical knowledge to organize and conduct preventive measures against infectious diseases with different mechanisms of transmission.  Training of specialists who have the necessary amount of theoretical and practical knowledge on issues of biosafety and the organization of preventive and countermeasures in emergency situations in peacetime, including the conditions of entry quarantine infections. The ultimate goals of discipline "Medical aspects of bioethics and biosafety":  acquisition algorithms organization of preventive measures against infectious diseases with different mechanisms of transmission;  acquisition algorithms organization of countermeasures for infectious diseases with different mechanisms of transmission;  acquisition algorithms organization and conduct preventive and countermeasures in emergency situations in peacetime, including the conditions of entry quarantine infections;  Expanding knowledge of existing and potential Biothreats and measures on their reins.

PROGRAM TRAINING COURSE

 I. General epidemiology Purpose:  To master basic epidemiological terms and concepts.  Identify the need for Deratization, Disinsection and Disinfection in a particular focus of infectious disease and methods of its implementation.  To be able to fill in documentation for registration of infectious patients. 7  Organize conducting of immunization. To be able to draw up a plan of vaccinations.  Provide legal justification of the scheduled and unscheduled vaccinations.  Execute documents (accounting and reporting) vaccination.  Identify priority issues for the prevention of infectious diseases and nosological groups, forms.  To interpret epidemiological, social and economic importance of certain forms of infectious diseases.  To apply techniques of epidemiological research methods (descriptive, analytical, experimental, prognostic).  Analyze the structure and level of morbidity by nosological forms.  Conduct an analysis of long-term and annual dynamics of disease, identify trends, cyclical and seasonal variations in the , morbidity compose forecast.  Able to investigate outbreaks of infectious diseases and to organize measures to eliminate them.  Identify groups, collectives, territory, time and risk factors for disease.  Be able to interpret the results of epidemiological studies and cohort studies case- control type.

Theme 1. Basic epidemiological terms and concepts. Modern epidemiological classification of infectious (parasitic) diseases. Subject of epidemiology. The primary and secondary driving forces of the epidemic process. The principles of modern epidemiological classification of infectious (parasitic) diseases. Theme 2. Structure of the epidemic process and measures of influence on his links. Sick people and the carrier, their epidemiological role. Categories carriers. Measures for decontamination of patients and carriers as sources of infectious diseases. Epidemiological significance of animals. Methods of human infection from animals. The role of rodents as a source of infectious agents to humans. The types and kinds of mechanisms of transmission of infectious agents. Susceptibility to infectious agents and its types. The principles of preventive and countermeasures. Theme 3. Deratization. Desinsection. The concept of deratization. Types and methods of Deratization. The concept of Disinsection. Types and methods of Desinsection. Quality control. Theme 4. Disinfection and sterilization. The concept of disinfection. Types and methods of disinfection. Classification of disinfectants. Disinfection of chamber principles of arrangement and description. Quality control of disinfection. The concept of sterilization. Stages of sterilization. Quality control of all phases of sterilization. 8 Theme 5. Immunization of infectious diseases. Calendar of preventive vaccinations. Legal aspects of vaccination. Types of immunity and their characteristics. The value of the level of population immunity in the population of infectious diseases. Calendar of preventive vaccination. Requirements for immunological agents. Methods of immunological drugs in the body. The list of medical contraindications to preventive vaccinations. Postvaccinal reactions and complications. Preparations for routine immunization (pharmaceutical form, method of administration, dose, response to input). Theme 6. Organization and carry out of vaccination. Evaluating the effectiveness of immunization. Urgent immunization. Organization of immunization. The plan of preventive vaccinations. Method of accounting records of immunization. Vaccination file cabinet. Evaluation of clinical, immunological and epidemiological effectiveness of immunization. Preparations for emergency immunization. Description of preparations for emergency prevention tetanus, rabies (pharmaceutical form, route of administration, dose, response to input). Theme 7. The system of preventive and countermeasures. Anti-epidemic work district (family) doctor and doctor of infectious disease, including in the foci of infectious diseases. Planning preventive and countermeasures. Ordered list of countermeasures. Ordered list of preventive measures. Focus of infectious disease. Survey of the foci of infectious disease. Fill in the relevant documentation. Measures for localization and liquidation of focus - measures in relation to the patient and the carrier, decontamination of the environment and people who contacted with a source of infection. Countermeasures in the focus - measures the components of the epidemic process. Planning preventive and countermeasures. Duties of district (family) doctor and infectious disease specialist on anti- epidemic work.

Theme 8. Epidemiology method of research and his structure. Analytical and experimental methods are in epidemiology researches. An estimation of problems of prophylaxis is on the basis of analysis of structure and level of morbidity after groups and nosology forms of infections. Epidemiology diagnostics. Operative epidemiology analysis. Retrospective epidemiology analysis. Study of displays of annual and long-term dynamics of morbidity. Prognostication of displays of epidemic process. An analysis of morbidity is after groups, collectives, territories. Planning of disease measures. Analytical and experimental epidemiology researches. The purpose and objectives of analytical epidemiological methods of investigation. Description and method of analytical survey "case-control" and cohort analytic study. Direct and relative risks of disease. Epidemiological . Screening Population Survey. Mathematical modeling in epidemiology. 9

 2. Special epidemiology and biosafety Purpose:

 Identify epidemiologic manifestations incidence of infection, belonging to different groups (respiratory, intestinal, transmissible and infections of external coverings).  Formulate working hypotheses about risk factors for disease areas, among different population groups and collectives regarding specific infectious diseases.  Interpret displays of epidemic process of concrete nosology forms belonging to different groups of infections: respiratory, intestinal, transmissible and infections of external coverings.  Organize preventive and countermeasures in the foci of specific entities that belong to different groups of infections: typhoid fever, shigellosis, hepatitis A, salmonella, botulism, polio, rotavirus infection, leptospirosis, diphtheria, measles, meningococcal disease, influenza, typhus Bryl fever and sickness, malaria, hepatitis B and C, HIV infection, tularemia, tick-borne encephalitis, hemorrhagic fevers Lassa, Ebola, Marburg, plague, cholera, anthrax.  Familiar with the concept of "biosafety".  Know the types of biological threats and principles response.  Organize countermeasures in emergency situations.

Theme 9. Preventive and countermeasures in the foci of infection with the fecal-oral mechanism of transmission (typhoid fever and paratyphoids, hepatitis A). Epidemiological characteristics of intestinal infections. Factors and transmission routes of specific nosological forms. Manifestations of the epidemic process (incidence, manifestations of disease in time, over areas of different populations and groups). Preventive and countermeasures in the foci of typhoid fever, paratyphoids, hepatitis A. Investigation of outbreaks of intestinal infections.

Theme 10. Preventive and countermeasures in the foci of infection with the air-borne mechanism of transmission (diphtheria, measles). The epidemiological characteristics of respiratory infections. Mechanisms, factors and transmission routes of specific nosological forms. Manifestations of the epidemic process (incidence, manifestations of disease in time, over areas of different populations and groups). Preventive and countermeasures in the foci of diphtheria and measles.

Theme 11. Preventive and countermeasures for infections with transmissible mechanism of transmission (malaria, Lyme disease). Epidemiological features infections with transmissible mechanism of transmission. Ways and factors of transmission of concrete nosologic forms. Displays of epidemic process (morbidity, displays of morbidity in time, for territories, among different populations and groups). Preventive and countermeasures in the foci of malaria and Lyme disease. 10

Theme 12. Preventive and countermeasures in the foci of infection with the contact mechanism of transmission (HIV infection, hepatitis B and C). Epidemiological features infections with the contact mechanism of transmission. Ways and factors of transmission of concrete nosologic forms. Displays of epidemic process (morbidity, displays of morbidity in time, for territories, among different populations and groups). Preventive and countermeasures in the foci of HIV infection, hepatitis B and C.

Theme 13. Preventive and countermeasures for health-care associated infections (HCAI). Epidemiology features of HCAI. Factors affecting the development of the epidemic process. Classification of HCAI. Major pathogens. Sources of agents, ways and factors of transmission of pathogens of HCAI. Groups and risk factors in various forms of these infections. Features of the organization and conduct preventive and countermeasures in medical institutions of different types.

Theme 14. Preventive and countermeasures at especially dangerous infections (cholera, plague, anthrax). Quarantine measures. Mechanisms, factors and transmission routes of specific nosological forms of especially dangerous infections. Manifestations of the epidemic process (incidence, manifestations of disease in time, over areas of different populations and groups). Preventive and countermeasures in the foci of cholera, plague, anthrax. Quarantine measures. Sanitary control of territory from skidding, the supply of especially dangerous infections.

Theme 15. Biological safety: basic concepts. Types of biological threats and system response. Features of countermeasures in cases of emergency. The concept of biological safety. The main types of biological threats. The system response to biological threats. Factors influencing the spread of infectious diseases in the areas of emergency. Features of epidemic process during an emergency. Basic principles of planning preventive and countermeasures in the areas of emergency. Protecting the population in emergencies. 11 STRUCTURE OF THE COURSE

Practical Self- Theme Lectures training studies I. General epidemiology 1. Epidemic process. Countermeasures in the foci of infectious 4 10 - diseases. 2. Immunization of infectious diseases. - 4 - 3. of research. 2 - 2. Special epidemiology 4. Hospital infection. The system of infection control. 4 2 - 5. Especially dangerous infections. Sanitary protection of borders. Countermeasures in the emergency situations. 1 2 - 6. Countermeasures in the foci of infectious diseases. 8 18 3. Biosafety and military epidemiology 7. Biological safety. Features of countermeasures in cases of 1 2 2 emergency. Total hours – 60 10 30 20 Credits ЕСТS – 2

THEME LECTURES Thematic plan of lectures on discipline "Epidemiology and biosafety"

Quantity # THEME hours 1 2 3 1. Epidemiology as a science and its place in modern structure of medical 2 sciences and public health services. Biological, social and environmental factors and mechanisms of development of epidemic processо. Self-regulation of parasitary systems. Natural foci of infectious diseases. 2. Features and objective laws of epidemic process. Directions of fight 2 against infectious diseases. Eradication of infectious diseases. The epidemiological diagnostics. The epidemiological surveillance. 3. Health-care associated infections (HCAI). Factors, which determine 2 the features of epidemiology and аssistance in the origin of HCAI. Epidemiology features of HCAIs of surgical-burned units, maternity units, as well as in outpatient settings (policlinic). 4. Epidemiology features of HCAI at different type of units. The system 2 of infection control. 5. Especially dangerous infections. Sanitary protection of the country 2 borders. Countermeasures in the time of emergency. TOTAL 10 12

THEME OF PRACTICAL CLASSES Thematic plan of practical classes on discipline "Epidemiology and Biosafety"

Quantit # THEME y hours 1 2 3 1. Basic epidemiological terms and concepts. Modern epidemiological 2 classification of infectious (parasitic) diseases. 2. Structure of the epidemic process and measures of influence on his links. 2 3. Deratization. Desinsection. 2 4. Disinfection and sterilization. 2 5. Immunization of Infectious Diseases. Calendar of preventive vaccinations. 2 Legal aspects of vaccination. 6. Organization and carry out of vaccination. Evaluating the effectiveness of 2 immunization. Urgent immunization. 7. The system of preventive and countermeasures. Anti-epidemic work district 2 (family) doctor and doctor of infectious disease, including in the foci of infectious diseases. Planning preventive and countermeasures. 8. Epidemiology method of research and his structure. Analytical and 2 experimental methods are in epidemiology researches. 9. Preventive and countermeasures in the foci of infection with the fecal-oral 2 mechanism of transmission (typhoid fever and paratyphoids, hepatitis A). 10. Preventive and countermeasures in the foci of infection with the air-borne 2 mechanism of transmission (diphtheria, measles). 11. Preventive and countermeasures for infections with transmissible mechanism 2 of transmission (malaria, Lyme disease). 12. Preventive and countermeasures in the foci of infection with the contact 2 mechanism of transmission (HIV infection, hepatitis B and C). 13. Preventive and countermeasures for Health-care associated infections (HCAI). 2 14. Preventive and countermeasures at especially dangerous infections (cholera, 2 plague, anthrax). Quarantine measures. 15. Biological safety: basic concepts. Types of biological threats and system 2 response. Features of countermeasures in cases of emergency. TOTAL 30

SELF-STUDIES WORKING Quantity # THEME Type of control hours 1. Preparation for practice - theoretical 20 Current control, preparation and practical skills situational problems TOTAL 20 13 THEMATIC PLAN OF SELF-STUDIES WORKING – PREPARATION FOR PRACTICE

Quantity # THEME hours 1. Epidemiological features (source of agent, factors and mode of 4 transmission, displays of epidemic process), preventive and countermeasures in the foci of the intestinal infectious diseases (shigellosis, salmonellosis, botulism, poliomyelitis, rotavirus infection, leptospirosis). 2. Epidemiological features (source of agent, factors and mode of 4 transmission, displays of epidemic process), preventive and countermeasures in the foci of the respiratory infectious diseases (flu, meningococcal infection). 3. Epidemiological features (source of agent, factors and mode of 4 transmission, displays of epidemic process), preventive and countermeasures in the foci of the transmissible diseases (epidemic typhus and Bril’ disease, tick-borne encephalitis, tularemia). 4. Hemorragic fevers (Ebola, Marburga, Lassa). Epidemiology features 4 (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 5. Regime-restrictive measures at observation and quarantine. Collective 4 and individual means of protection. Total 20

CONTROL METHODS

Evaluation - is one of the final stages of training activities and determine the success of training. Evaluation of the discipline is set as the average of the scores of all modules that are structured academic discipline. Forms of control and evaluation system pursuant to the requirements of the discipline and instruction about the assessment system for training of students, approved by the Ministry of Health of Ukraine (2005). Assessment for the module is defined as the sum of estimations of current educational activity in a traditional scale translated multimark scale for courses, followed by test that is proposed at the evaluation of theoretical knowledge and practical skills in accordance with lists defined discipline program. The maximum number of points that student in the learning module (test credits) – 200.

Evaluation of current training activities: Distribution points that get students To evaluate the knowledge of the discipline, the following types of control: current and final. The form is the final control test in accordance with the curriculum. Control measures include current and final semester control. Current control is carried out on each class according to the specific goals of 14 each topic and aims at checking mastering educational material. The form of the current control during training sessions: initial control of the material on topics of practical lessons and self-work; solving situational tasks and practical tasks; evaluation of the final level of knowledge. In evaluating the learning activities of students preferred standardized methods of control: testing, situational problems, structured written work and structured control (the procedure), practical skills in conditions close to reality. Evaluation of current educational activity. In evaluating the mastering of each topic for current educational activity the student score for the 4-point scale (traditional) scale taking into account the approved evaluation criteria for discipline. This takes into account all types of work, provided the curriculum. The student receives an assessment that is the average of all controls and ongoing training activities include control of theoretical and practical training. Exhibited the traditional assessment scale are converted into points. The maximum number of points that a student can collect for current educational activity at the study subjects is 200 points. The minimum number of points that a student must collect for current educational activity for enrollment courses is 120 points. Calculating the number of points is based on student evaluations received by traditional scale while learning subjects during the semester, by calculating the arithmetic (CA), rounded to two decimal places. The resulting value is converted into points by multi-scale as follows: � =(СА × 200) : 5 For convenience, a table converting 200-point scale: Table 1 Conversion of the average score for current activity in multimark scale for courses that are completed by test

200- 200- 4-point 200-point 4-point 4-point 4-point 200-point point point scale scale scale scale scale scale scale scale 5 200 4.45 178 3.92 157 3.37 135 4.97 199 4.42 177 3.89 156 3.35 134 4.95 198 4.4 176 3.87 155 3.32 133 4.92 197 4.37 175 3.84 154 3.3 132 4.9 196 4.35 174 3.82 153 3.27 131 4.87 195 4.32 173 3.79 152 3.25 130 4.85 194 4.3 172 3.77 151 3.22 129 4.82 193 4.27 171 3.74 150 3.2 128 4.8 192 4.24 170 3.72 149 3.17 127 4.77 191 4.22 169 3.7 148 3.15 126 4.75 190 4.19 168 3.67 147 3.12 125 4.72 189 4.17 167 3.65 146 3.1 124 4.7 188 4.14 166 3.62 145 3.07 123 15 4.67 187 4.12 165 3.57 143 3.02 121 4.65 186 4.09 164 3.55 142 3 120 Less than Not 4.62 185 4.07 163 3.52 141 3 enough 4.6 184 4.04 162 3.5 140 4.57 183 4.02 161 3.47 139 4.52 181 3.99 160 3.45 138 4.5 180 3.97 159 3.42 137 4.47 179 3.94 158 3.4 136

Self-study working of students is evaluated during the current control of theme on the appropriate lesson. Final control is carried out to assess learning outcomes at a particular educational qualification level and at the final stage of the discipline on a national scale and scale ECTS. Final control is carried out in the form of the discipline standings in the amount of educational material specified in the work program of the course and in the terms established working curriculum, individual curriculum the student. A student is admitted to the final control provided the requirements of the curriculum and if for current educational activity he scored at least 120 points during the practical exercises. Determination of the number of points that a student collected from discipline. Evaluation of the disciplines, form the final control test which is based on the results of current educational activities and expressed "Passed" or "not passed". To enroll a student must obtain for current learning activity score of at least 60% of the maximum amount of points in the discipline (120 points). Points converted regardless of discipline both in scale ECTS, and a 4-point scale. Score scale ECTS 4-point scale not converted and vice versa. Scores of students enrolled in one specialty, given the number of points gained in the discipline ranked on a scale ECTS as follows:

Table 2

Evaluation ЕСТS Statistical indicators А The best 10% of students В The following 25% of students С The following 30% of students D The following 25% of students E Latest 10% of students

Scores of discipline for students who completed the program successfully converted a traditional 4-point scale by absolute criteria, which are listed in the table below: 16 Table 3

Scores of discipline Score 4-point scale From 170 to 200 points "5" From 140 to 169 points "4" From 139 points to the minimum "3" number of points that a student must score Less than minimum number of points "2" that a student must score

Assessment ECTS in traditional scale not converted as the scale of ECTS and independent four-point scale. Objectivity evaluation of educational activities of students tested by statistical methods (correlation coefficient between ECTS assessment and evaluation on a national scale).

LIST of METHODOLOGICAL SUPPORT for CLASSES for IV year students of the Dentistry faculty

№ Topic Guidelines 1 2 3 1. Basic epidemiological terms. Guidelines Topical module 1. «Basic Three links of epidemic epidemiological terms. Reservoirs and sources of process and measures for the agents of infectious diseases. The them. mechanisms, modes and factors of transmission of the agents of infectious diseases» – 2014 – 31 p.

1. Guidelines' Topical module 1. "Basic epidemiological terms and concepts. Structure of epidemic process" for Vth year students in the fields of 7.12010001 - "Medicine", 7.12010002 - "Pediatrics", 7.12010003 - "Prophylactic medicine" training 1201 "Medicine" / Vynograd N.O. – Lviv: LNMU, 2015. – 40 p. 2. Guidelines' Topical module 2. "Deratization and Disinsection. Disinfection and Sterilization" for Vth year students in the fields of 7.12010001 - "Medicine", 7.12010002 - "Pediatrics", 7.12010003 - "Prophylactic medicine" training 1201 "Medicine" / Vynograd N.O. – Lviv: LNMU, 2015. – 58 p. 3. Guidelines' Topical module 3. "Vaccine prevention of infectious diseases. Schedule of vaccination. Legal aspects of vaccination" for Vth year students in the fields of 7.12010001 - "Medicine", 7.12010002 - "Pediatrics", 7.12010001 - "Prophylactic medicine" training 1201 "Medicine" / Vynograd N.O. – Lviv: LNMU, 2015. – 36 p. 4. Guidelines' Topical module 4. "Organization and carry out of immunization. 17 Estimation of efficiency of immunization. Urgent vaccination" for Vth year students in the fields of 7.12010001 - "Medicine", 7.12010002 - "Pediatrics", 7.12010003 - "Prophylactic medicine" training 1201 "Medicine" / Vynograd N.O. – Lviv: section of printing LNMU, 2015. – 37 p. 5. Guidelines' Topical module 5. "Epidemiological method and its components. Planning of the preventive and countermeasures. Countermeasures work of the family’ physician and infectionist doctor." for Vth year students in the fields of 7.12010001 - "Medicine", 7.12010002 - "Pediatrics", 7.12010003 - "Prophylactic medicine" training 1201" Medicine" / Vynograd N.O. – Lviv: LNMU, 2015. – 38 p. 6. Guidelines Topical module 6. "Epidemiological method, structure and maintenance ones. Planning of the preventive and countermeasures. Analytical and experimental methods in epidemiological study" for Vth year students in the fields of 7.12010001 - "Medicine", 7.12010002 - "Pediatrics", 7.12010003 - "Prophylactic medicine" training 1201 "Medicine" / Vynograd N.O. – Lviv: section of printing LNMU, 2015. – 53 p. 7. Guidelines' Topical module 7. "Countermeasures in a focus of the intestinal infectious diseases (dysentery, typhoid, paratyphoid, hepatitis A)" for Vth year students in the fields of 7.12010001 - "Medicine", 7.12010002 - "Pediatrics", 7.12010003 - "Prophylactic medicine" training 1201 "Medicine" / Vynograd N.O. – Lviv: section of printing LNMU, 2015. – 38 p. 8. Guidelines' Topical module 8. "Countermeasures in a focus of the respiratory infectious diseases (diphtheria, measles, flu, meningococcal infection)" for Vth year students in the fields of 7.12010001 - "Medicine", 7.12010002 - "Pediatrics", 7.12010003 - "Prophylactic medicine" training 1201 "Medicine" / Vynograd N.O. – Lviv: section of printing LNMU, 2015. – 32 p. 9. Guidelines' Topical module 9. “Preventive and countermeasures attached HIV/AIDS, hepatitis B and C. Preventive and countermeasures attached to especially dangerous infectious diseases (cholera, plague, and anthrax). Quarantine measures” for Vth year students in the fields of 7.12010001 - "Medicine", 7.12010002 - "Pediatrics", 7.12010003 - "Prophylactic medicine" training 1201 "Medicine" / Vynograd N.O. – Lviv: section of printing LNMU, 2015. – 30 p. 10. Guidelines' for self-study for Vth year students in the fields of 7.12010001 - "Medicine", 7.12010002 -"Pediatrics", 7.12010003 - "Prophylactic medicine" training 1201" Medicine" / Vynograd N.O. – Lviv: section of printing LNMU, 2015. – 62 p.

A LIST OF QUESTIONS SUBMITTED TO THE CURRENT CONTROL

1: General epidemiology 1. Object and tasks of epidemiology. 2. Milestones epidemiology (D. Samoilovich, D.K. Zabolotny, L.V. Gromashevsky, V.D. Belyakov). 18 3. Epidemic process and its components. 4. Sections of the doctrine of the epidemic process. 5. The driving forces of the epidemic process. 6. Features of epidemic process in anthroponoses and zoonoses. The concept of sapronoses. 7. Quantitative and qualitative manifestation of the epidemic process. 8. Countermeasures in the foci of infectious diseases. 9. Focus of infectious disease. Directions conduct epidemiological survey of. 10.What are stipulated limits of infectious disease? Give examples. 11.The purpose and objectives of epidemiological survey of focus. 12.How is the detection of infectious patients and report them? 13.Cabinet of infectious diseases (CID) and its functions. 14.The source and reservoir of infectious diseases. 15.Sick people and carrier and their epidemiological value. 16.Categories of carriers of infectious diseases. 17.Measures for disinfection of patients and carriers as sources of infectious diseases. 18.Epidemiological significance of animals (rodents, pets, etc.). 19.The concept of deratization, typss and methods. 20.Theory of mechanism of transmission of infectious agents by L.V. Gromashevsky. Determining the mechanism of transmission, its managers. Factors and routs of transmission of infectious diseases. 21.Laws matching specific transmission mechanism (epidemiology) localization of the pathogen in humans. 22.Types mechanisms of transmission of infectious diseases. 23.Epidemiological significance of arthropods (mosquitoes, flies, ticks, lice, fleas, etc.) as carriers of infectious diseases. Types and methods of disinfection. 24.Determination of disinfection, its types and methods. Quality control of disinfection. 25.Disinfection chambers and principles of their appointment. 26.Sterilization and its stages, quality control. 27.Calendar of preventive vaccinations in Ukraine. Legal aspects of vaccine. 28.Planing of preventive vaccinations. 29.Fill accounting records about vaccination. 30.The basic regulations in the field of epidemiology. 31.Epidemiology method of research, its structure. 32.Descriptive-evaluation method of epidemiology method. 33.Epidemiological, social and economic importance of infectious diseases. 34.Levels of evidence in medicine. 35.The operative epidemiological analysis. 36.The method of conducting retrospective epidemiological analysis. 37.The analysis of long-term and annual dynamics of morbidity. 38.Displays of epidemic process in listing many years dynamics and reasons that cause them. 39.Analysis of the spatial distribution of disease. 19 40.Displays of epidemic process in the annual dynamics of morbidity and reasons that cause them. 41.The structure and level of morbidity for teams, groups and nosologic forms. 42.The concept of territory, groups, time and risk factors. 43.The value of social factors in the development of the epidemic process. 44.The value of natural factors in the development of the epidemic process. 45.Analytical and experimental research methods of epidemiological method. 46.The essence of the analytical study of the "case-control". 47.The essence of analytic . 48.Determination of epidemiological experiment (controlled, uncontrolled, natural). 49.Prediction of displays of epidemic process. 50.The purpose and peculiarity of the organization the screening population. 51.Mathematical modeling in epidemiology and their values 52.Planning preventive and countermeasures.

2: Special epidemiology and biosafety 1. Epidemiologic classification of infectious diseases. 2. Epidemiological features of intestinal infections. 3. Epidemiological features of respiratory infections. 4. Epidemiological features of transmissible infections. 5. Epidemiological features of infections of external coverings. 6. Epidemiology and prevention of health-care associated infections (HCAI). 7. The sanitary protection of the territory of Ukraine from skidding and spreading of quarantine infections. 8. Preventive and countermeasures for the most common diseases. 9. Quarantine measures on espessialy dangerous infectious diseases. 10. Typhoid fever. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 11. Paratyphoid A and B. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 12. Hepatitis A. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 13. Shigellosis. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 14. Salmonellosis. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 15. Botulism. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 16. Poliomyelitis. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 17. Rotavirus infection. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 18. Leptospirosis. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 20 19. Cholera. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 20. Diphtheria. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 21. Measles. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 22. Influenza (flu). Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 23. Meningococcal infection and purulent bacterial meningitis. Etiological structure of purulent bacterial meningitis, epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 24. Hepatitis B. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 25. Hepatitis C. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 26. HIV infection. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 27. Anthrax. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 28. Malaria. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 29. Epidemic typhus and Bril’ disease. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 30. Lyme disease. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 31. Tick-borne encephalitis. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 32. Tularemia. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 33. Plague. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 34. Hemorrhagic fever Ebola and Marburg. Epidemiological features (source of agent, factors and mode of transmission, displays of epidemic process), preventive and countermeasures. 35. Lassa haemorrhagic fever. Epidemiological features (source of agent, factors and mode of transmission,), preventive and countermeasures. 36. Health-care associated infections (definition, relevance, classification and structure of epidemic process). 37. Health-care associated infections (pathogens, nosological forms, causes and conditions of occurrence and spread). 38. Epidemiological features and prevention of health-care associated infections in surgical and burn hospitals. 21 39. Epidemiological features and prevention of health-care associated infections in urological hospitals. 40. Risk factors for nosocomial pneumonia occurrence and measures for their prevention. 41. Factors which determine the formation displays of epidemic process of health-care associated infections. 42. Preventive measures for health-care associated infections. 43. Epidemiological surveillance of health-care associated infections. 44. Types of biothreats. 45. Classification emergencies. 46. The development of the epidemic process in the population in emergencies. 47. Factors which determine spreading of infectious diseases in the areas of emergency. 48. The principles of protection in the area of emergency. 49. Collective and individual means of protection.

List of practical tasks

1. Definition forecast the incidence of next year trend line long-term dynamics of morbidity. 2. Determining the level of infection in the population according to sample laboratory research and its epidemiological assessment. 3. Fill annual «Report on certain infectious and parasitic diseases» (form №2). 4. Fill in the register of infectious diseases (form №60). 5. Filling emergency notification newly diagnosed infectious or parasitic disease (form №58). 6. Fill preventive vaccination card (form №63) and individual card of the child (form 112). 7. Determination of the effectiveness of vaccination and epidemiological evaluation. 8. Justification list of preventive measures in the foci of infectious diseases. 9. Building diagrams for illustrative presentation of epidemiological data and identifying groups of risk factors and morbidity. 10. The selection of material for bacteriological study on diphtheritic infection. 11. Determination of the seasonal dynamics of annual incidence of disease distribution diagram of months of the year and its evaluation. 12. Assessment of quality of disinfection and sterilization in the foci of hepatitis A and B. 13. Carrying out countermeasures in the focus of intestinal, respiratory, transmissible and contact infections. 22 REFERENCES

Basic literature

1. Bryan Kestenbaum Epidemiology and Biostatistics: An Introduction to Clinical Research 2nd ed. 2019, 292 p. 2. Antonisamy B., Prasanna S. Premkumar, Christopher S. Principles and Practice of Biostatistics, Publisher: Elsevier India. 2017, 390 p. 3. Krieger N. Epidemiology and the People's Health: Theory and Context. Oxford University Press; 1 edition, 2014, 400 p. 4. Smith Th. J., Kriebel D. A. Biologic Approach to Environmental Assessment and Epidemiology. Oxford University Press, 2010 5. Giesecke J. Modern Infectious Disease Epidemiology. ISBN-10: 1444180029, CRC Press; 3 edition, 2017, 481 p.

6. Hamborsky J., Kroger A. Epidemiology and Prevention of Vaccine-Preventable Diseases The Pink Book: Course Textbook - 13th Edition, 2015, 375 p. 7. Kobeissy F., Alawieh A., Wang K. et al. Leveraging Biomedical and Healthcare Data. Semantics, Analytics and Knowledge, Elsevier Inc. 2019, 225 p. https://doi.org/10.1016/C2015-0-06232-3 8. Maurice J. M., Davey Sh. State of the World's Vaccines and Immunization: 2009. World Health Organization, 2009. 9. Bloomfield S. et al. The infection risks associated with clothing and household linens in home and everyday life settings, and the role of laundry. International Scientific Forum on Home Hygiene, 2013. https://www.ifh-homehygiene.org › sites › default › files › publications 10.Last J.M. A Dictionary of Epidemiology. Oxford University Press: NY, 2001. http:/www.oup-usa.org. 11.Battin M.P., Francis L.P., Smith Ch.B. The Patient as Victim and Vector: Ethics and Infectious Disease. Oxford University Press: NY, 2009 12.Nelson K.E., Williams C.M. Infectious Disease Epidemiology. Theory and practice. 2d Edition. Jones and Bartlett Publishers, Sudbury Massachusetts, 2004 13.Brownson C. Applied epidemiology: theory to practice. Oxford University Press, 2006 14. Plotkin S.A., Orenstein W.A., Offit P.A. Vaccines. Elsevier Health Sciences, 2008. 15.Brownson C. Applied epidemiology: theory to practice. Oxford University Press, 2006. 16. Murray Ch. J. L., Lopez A. D., Mathers C. D. The global epidemiology of infectious diseases [electronic resource] - wholibdoc.who.int/.../2004/9241592303.pd 17. Infectious Disease Epidemiology Manual – www.biotech.law.lsu.edu/PH/ 23 18. Murray Ch. J. L., Lopez A. D., Mathers C. D. The global epidemiology of infectious diseases [electronic resource] - wholibdoc.who.int/.../2004/9241592303.pd

Additional sources: 1. World Health Organization - http://www.who.int 2. National Library of Medicine – http:/www.nlm.nih.gov 3. World Wide Web Virtual Library – Epidemiology http://chanane.ucsf.edu/epidem/epidem.html 4. Archive Epidemiology and Infection - www.ncbi.nlm.nih.gov/pmc/journals 5. Behavioral Risk Factor Surveillance System https://www.cdc.gov/brfss/ 6. Global action plan on antimicrobial resistance https://www.who.int/antimicrobial- resistance/publications/global-action-plan/en/ 7. Health Technical Memorandum 01-04: Decontamination of linen for health and social care http:// www.gov.uk/government/collections/ health-building-notes- core-elements 8. Infection Control in Health Care Facilities https://www.cdc.gov/flu/professionals/infectioncontrol/ 9. Immunization Managers https://www.cdc.gov/vaccines/imz-managers/