# Endemic (epidemiology)

In epidemiology, an infection is said to be endemic (from Greek ἐν en "in, within" and δῆμος demos "people") in a population when that infection is constantly maintained at a baseline level in a geographic area without external inputs.[1] For example, chickenpox is endemic (steady state) in the UK, but malaria is not. Every year, there are a few cases of malaria reported in the UK, but these do not lead to sustained transmission in the population due to the lack of a suitable vector (mosquitoes of the genus Anopheles). While it might be common to say that AIDS is "endemic" in Africa, meaning found in an area, this is a use of the word in its etymological, rather than epidemiological, form. AIDS cases in Africa are increasing, so the disease is not in an endemic steady state. It is correct to call the spread of AIDS in Africa an epidemic.[2]

For an infection that relies on person-to-person transmission to be endemic, each person who becomes infected with the disease must pass it on to one other person on average. Assuming a completely susceptible population, that means that the basic reproduction number (R0) of the infection must equal 1. In a population with some immune individuals, the basic reproduction number multiplied by the proportion of susceptible individuals in the population (S) must be 1. This takes account of the probability of each individual to whom the disease may be transmitted being susceptible to it, effectively discounting the immune sector of the population. So, for a disease to be in an endemic steady state it is: ${\displaystyle R_{0}\times S=1}$

In this way, the infection neither dies out nor does the number of infected people increase exponentially but the infection is said to be in an endemic steady state. An infection that starts as an epidemic will eventually either die out (with the possibility of it resurging in a theoretically predictable cyclical manner) or reach the endemic steady state, depending on a number of factors, including the virulence of the disease and its mode of transmission.

If a disease is in endemic steady state in a population, the relation above allows us to estimate the R0 (an important parameter) of a particular infection. This in turn can be fed into the mathematical model of an epidemic.

## References

1. ^ "Principles of Epidemiology in Public Health Practice, Third Edition An Introduction to Applied Epidemiology and Biostatistics". Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. Retrieved 19 April 2018.
2. ^ "HIV and AIDS in East and Southern Africa regional overview". AVERT. 20 July 2015.
Epidemic

An epidemic (from Greek ἐπί epi "upon or above" and δῆμος demos "people") is the rapid spread of infectious disease to a large number of people in a given population within a short period of time, usually two weeks or less. For example, in meningococcal infections, an attack rate in excess of 15 cases per 100,000 people for two consecutive weeks is considered an epidemic.Epidemics of infectious disease are generally caused by several factors including a change in the ecology of the host population (e.g. increased stress or increase in the density of a vector species), a genetic change in the pathogen reservoir or the introduction of an emerging pathogen to a host population (by movement of pathogen or host). Generally, an epidemic occurs when host immunity to either an established pathogen or newly emerging novel pathogen is suddenly reduced below that found in the endemic equilibrium and the transmission threshold is exceeded.An epidemic may be restricted to one location; however, if it spreads to other countries or continents and affects a substantial number of people, it may be termed a pandemic. The declaration of an epidemic usually requires a good understanding of a baseline rate of incidence; epidemics for certain diseases, such as influenza, are defined as reaching some defined increase in incidence above this baseline. A few cases of a very rare disease may be classified as an epidemic, while many cases of a common disease (such as the common cold) would not.

Ticks of domestic animals

Ticks of domestic animals directly cause poor health and loss of production to their hosts by many parasitic mechanisms. Ticks also transmit numerous kinds of viruses, bacteria, and protozoa between domestic animals. These microbes cause diseases which can be severely debilitating or fatal to domestic animals, and may also affect humans. Ticks are especially important to domestic animals in tropical and subtropical countries, where the warm climate enables many species of ticks to flourish. Also, the large populations of wild animals in warm countries provide a reservoir of ticks and infective microbes that spread to domestic animals. Farmers of livestock animals use many methods to control ticks, and related treatments are used to reduce infestation of companion animals.

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