What does an epidemiologist do? Epidemiologist: features of specialization

An epidemiologist is a specialist who studies epidemics, that is, mass diseases, and measures to counter them.

The duties of an epidemiologist include: analysis of the epidemiological situation in a particular region, study of foci of infection, development of measures aimed at suppressing the epidemic and their prevention in the future.

Epidemiologists perform control over enterprises Catering, the operation of treatment facilities and other institutions whose activities may harm the health and life of the population.

In epidemiology, there are six areas:

1. Epidemiology infectious diseases - the most important part of general science, which arose one of the first in the time of Hippocrates. He is engaged in studying the ways of spreading bacteria and viruses, including especially dangerous ones, and organizes anti-epidemic measures, and also develops methods for the prevention of infectious diseases. The well-known vaccination, which put a barrier to epidemics especially dangerous infections- this is the result of the work of specialists in this area;
2. Epidemiology of noncommunicable diseases- the scope of this direction is the study and development of measures to counteract diseases that take the scale of epidemics, but are not caused by infectious agents. An example is cardiovascular disease, diabetes, cancer;
3. Military epidemiology- provides anti-epidemic measures against the army in wartime and peacetime;
4. landscape epidemiology- the study of mass morbidity in any region associated with the characteristics of the area, including carriers of diseases living there. An example of a disease that landscape epidemiologists deal with is tick-borne encephalitis;
5. Environmental epidemiology- studies cases of mass diseases of people caused by unfavorable environmental conditions. For example, the impact of factory emissions on the incidence of lung cancer in a particular locality is being studied;
6. Pharmacoepidemiology- a science formed by the fusion of pharmacology and epidemiology. In her area of ​​interest pharmacological preparations for large groups of people, optimization of the distribution of pharmaceuticals, the formation of lists of essential drugs and recommendations for their use, depending on the epidemiological situation in a particular area.

When should an epidemiologist be consulted?

The epidemiologist works with large amounts of information without direct contact with the patient. Figuratively speaking, if doctors of other specialties save people, then epidemiologists save entire populations.

Most often in everyday life, people encounter the results of the work of epidemiologists when vaccinating - whether it is routine vaccination of children or anti-rabies vaccinations (against rabies). But even in this case, the patient does not directly encounter the epidemiologist.

Epidemiological diagnostics combines the methods of studying the process of the spread of diseases, the factors contributing to this and assessing the epidemic situation in a particular area. This is a very important task, since the result of epidemiological diagnostics is the forecast of the epidemic situation and the development of measures to counter possible or existing epidemics.

The following methods of epidemiological diagnostics are used:

• Descriptive-evaluative;
• Information analysis;
• Experimental (proposing certain hypotheses and testing them);
• Forecast.

The results of the work carried out are:

• Recommendations regarding behavior in a certain epidemiological situation;
• Development of measures to counter mass diseases (development of a set of rules for doctors regarding the treatment of a disease that has become widespread);
• Prevention of epidemics (including immunization of the population and health education).

To some, the work of an epidemiologist may seem boring and not as important as, say, the work of a surgeon, but this is far from the case. Throughout its history, mankind has literally stood on the verge of extinction several times due to epidemics - remember the terrible epidemics of the plague, the “black death”, which mowed down entire countries. In order to prevent this from happening again, so that epidemics of cholera, smallpox, and diphtheria do not return, epidemiologists are working.

New times form new challenges, not letting us rest on our laurels. To defeat tuberculosis, to stop the AIDS epidemic, to cope with the scourge of our time - cardiovascular diseases - this is an incomplete list of the tasks of modern epidemiology.

An epidemiologist is a doctor who counteracts mass infections (epidemics, pandemics), organizes the treatment and prevention of the spread of epidemics.

The profession of an epidemiologist involves not so much the fight against infection as the study of the causes of epidemics and the study of incidence: analysis by region, examination of foci and sources of infection, development of a scheme for eliminating the epidemic. Also, the epidemiologist is engaged in the control of the epidemiological situation at public catering enterprises, water utilities, filtration stations of large factories that pollute the environment.

An epidemiologist does not directly treat patients, does not receive patients, but saves a huge number of people, being responsible for the process of immunization (vaccination) of the population. This also applies to routine vaccinations, and emergency vaccination against rabies, for example. In addition, at the hospital stage, he deals with a number of diseases:

• Koch's bacillus infection.
• Cholera, AKI, typhoid fever.
• Diphtheria, chickenpox, measles, other childhood infections.
• Tetanus.
• Viral hepatitis.
• Polio.
• Bronchial asthma.
• coronary artery disease ( ischemic disease hearts).
• Tumors.
• Plague.
• Borreliosis and encephalitis.
• FMD.
• Malaria.
• Rabies.

Epidemiologists work closely with internists and pediatricians, microbiologists, immunologists, pharmacologists, hygienists and public health officers.

The specialist does not treat or receive patients, but is responsible for vaccinating the population.

Differences between an epidemiologist and an infectious disease specialist

Differences between an epidemiologist and a virologist and a microbiologist

Directions of epidemiology

• Infectious epidemiology- studies the spread of bacteria and viruses, organizes an anti-epidemic barrier, sanitizes infections, develops vaccines.
• Noninfectious epidemiology- Eliminates epidemics of a non-infectious nature (for example, diabetes mellitus, oncological processes, dangerous diseases of the heart and blood vessels).
• Military epidemiology- monitors the epidemiological situation in the army.
• landscape epidemiology- deals with regional epidemics, their pathogens, terrain features, conditions of occurrence. For example, the migration of ticks and outbreaks of epidemics of encephalitis and borreliosis in the regions.
• Environmental epidemiology- studies diseases that arise due to unfavorable ecology. For example, asthma in the areola of an oil refinery.
• Pharmacoepidemiology- studies influence medicines per person, maintains a list of medicines involved in the elimination of epidemics.

Places of work

The position of an epidemiologist is available in the laboratories of large clinics, research institutes, the Central District Hospital, regional hospitals, perinatal centers, maternity hospitals, SES, large industrial and agricultural associations.

History of the profession

As soon as infectious diseases appeared on Earth, people began to fight them. It was a question of the survival of the human population. Initially, epidemiological knowledge was empirical, based on random guesses. Their accumulation led to the formation of epidemiology as an independent science. Conventionally, the entire period of development of epidemiology can be divided into several stages:

• Empirical, pre-Hippocratic - until the 5th century BC.
• Associated with the name of Hippocrates. The causes of mass diseases are being investigated - up to the 16th century.
• The period before the discovery of pathogens of pathologies - up to the second half of XIX century (T. Sydenheim, D. Frakostoro, E. Jenner, D. Samoylovich).
• The era of the discovery of bacteria - until the beginning of the twentieth century (R. Koch, L. Pasteur, I. Mechnikov, N. Gamaleya).
• Establishment of epidemiology as an independent science (I. Elkin, D. Zabolotny, L. Gromashevsky).

Currently, epidemiology studies nosocomial infections, the detection of diseases of a previously unknown etiology, the so-called creeping, slow epidemics: herpes, cytomegalovirus, borreliosis, AIDS. It should be emphasized that annually in the United States alone, the economic damage from influenza, for example, is about 5 billion dollars, which speaks better than any words about the importance of developing epidemiology.

The latest developments of epidemiologists are devoted to mixed infections, a combination of two or three diseases of different genesis, the evolution of the pathogenicity of already well-known microbes, and the virulence of opportunistic bacteria and viruses.

Cytomegalovirus is one of the viruses that epidemiology is fighting against.

Duties of an epidemiologist

The main duties of an epidemiologist are:

• Departure to the epicenter of the epidemic, examination of contact persons, registration and accounting of data.
• Laboratory studies to identify the pathogen, take appropriate treatment and prevention measures.
• Control of the sanitary and epidemic regime in a medical facility. Prevention of nosocomial infections, elimination of infectious foci.
• Development of the vaccination calendar and its implementation.
• Providing vaccines to all interested parties.
• Development preventive measures to prevent epidemics.
• Close cooperation with SES.
• Preparation of primary documentation.

Requirements for an epidemiologist

The basic requirements for an epidemiologist include:

• Higher medical education, valid accreditation sheet in epidemiology.
• Knowledge of the basics of disaster medicine and the legislation of the Russian Federation.
• Skills of working on a PC in the system of a single clinic information system.
• Knowledge of the principles of morality and medical ethics.

Work in the laboratory is only part of the work of a specialist.

How to become an epidemiologist

To become an epidemiologist, you must:

• Graduate from a university or medical school with a degree in General Medicine or Pediatrics.
• Get an accreditation sheet. To do this, you need to pass the exam and successfully pass an interview with an expert commission.
• After that, you can work with patients on an outpatient basis (for example, a general practitioner or pediatrician).
• To obtain a narrow specialization, you can enroll in residency (2 years of study) in the specialty "Epidemiology". Paid easier, because the competition is small and for admission you need to have only 50 attestation points. For free You can get into residency in two ways: by competition on a general basis or by the target referral of the head physician of a medical organization in which the specialist is already working.

Each year, doctors are required to score 50 certification points. To do this, you can take advanced training courses (36 points), attend scientific and practical conferences (the number of points depends on the event, but usually about 10 points), publish scientific papers, write books, defend dissertations. If enough points are scored, then you can work further. If points are not scored, then you will either have to stop medical practice, or solve this problem in “non-standard” ways.

The experience, skill and quality of the doctor's work is usually assessed qualification categories which can be obtained by defending a research paper. During the defense, the commission evaluates the doctor's skills in the field of diagnosis, treatment, prevention, as well as the relevance of his knowledge.

What are the qualification categories?

• the second - over 3 years of experience;
• the first - more than 7 years of experience;
• higher - more than 10 years of experience.

The qualification category allows you to hold high positions in medical institutions, entitles you to a salary increase, gives you status in a professional environment and high confidence on the part of patients. Even more respect can be achieved by speaking at conferences, symposiums and creating scientific articles and papers.

The doctor has the right not to qualify, but this will hinder his career and professional growth.

Epidemiologist salary

The general income range is as follows: epidemiologists earn from 7,500 to 60,000 rubles a month. Most of the vacancies for an epidemiologist are in the Moscow region. We found the lowest salary for a doctor in Taganrog: 7,500 rubles a month; the largest - in the Moscow City Hospital No. 64: 60,000 rubles per month.

The average salary of an epidemiologist is 18,000 rubles per month.

Where to get training

In addition to higher education, there are a number of short-term studies on the market lasting, as a rule, from a week to a year.

Medical University Innovation and Development invites you to take distance courses for retraining or advanced training in the direction of "" with a diploma or state certificate. Training lasts from 16 to 2700 hours, depending on the program and your level of preparation.

1. General Provisions

1. This job description defines the job duties, rights and responsibilities of an epidemiologist in an outpatient clinic.
2. A person with a higher medical education who has completed postgraduate training or specialization in the specialty "Epidemiology" is appointed to the position of an epidemiologist in an outpatient clinic.
3. An epidemiologist must know the basics of the Russian Federation legislation on healthcare; legal documents regulating the activities of healthcare institutions and state sanitary and epidemiological supervision; basics of organization of medical and preventive care in hospitals and outpatient clinics, ambulance and emergency medical care, services of disaster medicine, sanitary and epidemiological service, drug supply of the population and health care facilities; theoretical foundations, principles and methods of clinical examination; organizational and economic foundations for the activities of health care institutions and medical workers in the context of budgetary insurance medicine; fundamentals of social hygiene, organization and economics of healthcare, medical ethics and deontology; legal aspects of medical activity; general principles and basic methods of clinical, instrumental and laboratory diagnostics functional state of organs and systems of the human body; etiology, pathogenesis, clinical symptoms, course features, principles of complex treatment of major diseases; rules for the provision of emergency medical care in a life-threatening condition of the patient; fundamentals of health education; internal labor regulations; rules and norms of labor protection, safety measures, industrial sanitation and fire protection.
In his specialty, an epidemiologist should know modern methods prevention, diagnosis, treatment and rehabilitation; content and sections of epidemiology as an independent clinical discipline; tasks, organization, structure, staffing and equipment of the epidemiological service; current legal and instructive and methodological documents in the specialty; rules for issuing medical documentation; principles of activity planning and reporting of the epidemiological service; methods and procedures for monitoring its activities.
4. An epidemiologist is appointed to a position and dismissed by order of the chief doctor of a medical facility in accordance with the current legislation of the Russian Federation.
5. The epidemiologist reports directly to the head of the medical facility or his deputy.

2. Job responsibilities

The epidemiologist has the right:
1. to make proposals to the management of the institution on improving the diagnostic and treatment process, improving the work of administrative, economic and paraclinical services, issues of organization and conditions of their work;
2. control the work of subordinate employees (if any), give them orders within the framework of their official duties and demand their precise execution, make proposals to the management of the institution on their encouragement or imposition of penalties;
3. request, receive and use information materials and legal documents necessary for the performance of their official duties;
4. to take part in scientific and practical conferences and meetings, which discuss issues related to his work;
5. pass certification in accordance with the established procedure with the right to obtain the appropriate qualification category;
6. to improve their qualifications at refresher courses at least once every 5 years.
An epidemiologist enjoys all labor rights in accordance with the Labor Code of the Russian Federation.

4. Responsibility

The epidemiologist is responsible for:
1. timely and high-quality implementation of the duties assigned to him;
2. organization of their work, timely and qualified execution of orders, instructions and instructions of the management, regulatory legal acts on their activities;
3. compliance with internal regulations, fire safety and safety;
4. timely and high-quality execution of medical and other service documentation provided for by the current legal documents;
5. providing, in accordance with the established procedure, statistical and other information on their activities;
6. Ensuring compliance with executive discipline and performance of their duties by subordinate employees (if any);
7. prompt action, including timely informing the management, to eliminate violations of safety, fire and sanitary rules that pose a threat to the activities of the healthcare institution, its employees, patients and visitors.
For violation of labor discipline, legislative and regulatory acts, an epidemiologist may be brought to disciplinary, material, administrative and criminal liability in accordance with the current legislation, depending on the severity of the offense.

Epidemiology is the science of the origin, spread and prevention of diseases. An epidemiologist is a doctor who analyzes these phenomena, develops and implements ways to counter infectious diseases.

It still has the responsibility to carry out a thematic analysis of the epidemiological situation. With its help, a specific plan of anti-epidemic measures is drawn up, which is extremely necessary when a focus of an infectious disease is detected.

The epidemiologist organizes measures to prevent infectious diseases at all stages of the epidemic process. This:

• localization of the source of infection;
• impact on the spread of the disease;
• susceptible tracking.

An epidemiologist is obliged in a short time to protect the spread of pathogens of an infectious disease, monitor the correctness of anti-epidemic measures, and monitor effective vaccination of the population.

Today, this work is indeed classified as relatively rare. Specialists have to study the patterns of occurrence and subsequent spread of various infectious diseases.

Epidemiologists work in every district and at the level of settlements.

According to the classification, epidemiology as a science is positioned under a diagnostic discipline from the field of preventive healthcare. It is not for nothing that the term literally translates as “epi” - “on”, “demos” - “people”. Already in ancient times, doctors began to use this term to designate sharp outbreaks of diseases in a strictly defined area.

Initially, science was at a primitive level, because of which, during outbreaks of cholera or plague, people died by the thousands. Over time, experts have developed a set of preventive measures to combat these infections.

Even when people did not yet have specialized equipment for microbiological or biochemical analysis, they could already draw up at least the simplest summary of preventive measures. Through trial and error, it became clear that the preventive program not only brings results, but also prevents a large percentage of deaths.

Acquired knowledge about proper nutrition and other points of proactive work has reduced the risks of mass outbreaks to almost nothing:

• smallpox;
• cholera;
• tuberculosis.

In recent decades, this branch of medicine has experienced a special revival, which is explained by the opportunity to identify the etiology of ailments. A striking example of this was the study of pregnant women who gave birth to babies with deformities. For a long time, scientists could not find any connection until, in a complex of studies, they began to determine the viral component, analyze the course of pregnancy and the manifestations of infectious processes during childbearing, which made it possible to find the cause of all misfortunes - rubella during pregnancy.

Modern approach

The epidemiologist not only directly monitors the disease itself and the spread of the disease among the population, but also compares the data obtained with other conditions:

• natural;
• social;
• economic;
• ecological.

If all of the above parameters are taken into account, then it will be possible not only to localize the epidemic, but also to create quality program preventive measures.

Even the consideration of the problem of AIDS began precisely with the interest of epidemiologists. Collecting the next congress, the doctors tried to compare the causes of the outbreak of pneumocystis pneumonia among a certain circle of patients. Congress prompted other physicians to take up the study of such a strange situation closely.

But if AIDS is still being fought fiercely in the laboratories of leading universities, then with many other diseases the situation has improved significantly after the intervention of epidemiologists. Together, the World Health Organization was able to eliminate smallpox, which posed a real threat to people around the globe.

These are all the basics of epidemiological diagnosis. But even this is not always enough. Reports are needed on the population size, organized groups and natural factors up to the air temperature that affects the development of the disease.

World classification

Epidemiologists identify various factors of interest in their own research. The classification provides for the following groups:

• noncommunicable diseases;
• military;
• landscape;
• ecological;
• pharmacoepidemiological.

The first point was not even originally part of the medical unit, but later the employees of the epidemiological center became interested in it, wishing to do this as well. Doctors who previously dealt only with situations with infectious agents are now responsible for researching mass cardiovascular diseases, oncology and other similar ailments.

A separate line was given to the military unit. Here, the hospital specialized doctor must monitor the situation not only in wartime, but also in peacetime. It's just that his duties include exclusively caring for army teams.

Another unusual section is the landscape direction. It is based on distinctive characteristics selected area where a huge number of carriers of infection accumulate. For example, tick-borne encephalitis is just from this camp.

With the ecological branch, everything is relatively clear, since here the main pillars of the definition of diseases are unfavorable factors. environment. These can be both factory emissions into the air and effluents from plants into the nearest river.

The final representative is pharmacoepidemiology, whose responsibilities included the study of the effect of drugs on groups of people. The same doctors are responsible for the formation of a list of essential medicines, depending on the current morbidity situation.

When to book an appointment?

The generally accepted recommendations for visiting this doctor are based on the detection of classic symptoms of infectious diseases. And although usually with this people rush to an appointment with a specialized doctor like an otolaryngologist, or a local therapist, job descriptions epidemiologists also provide for the reception of citizens.

It is necessary to sound the alarm if the patient is faced with:

• elevated body temperature;
• fever;
• rash;
• sore throat or plaque in it;
• discharge from the nose, ears, eyes;
• increased fatigue.

Despite the fact that the signs of damage to the body by pathogens often have a similar picture, an experienced epidemiologist will be able to see the nuances and send them for a clinical examination.

The list of the most common diseases that have come under the jurisdiction of a person with such a rare profession includes:

• hepatitis C and B;
• flu;
• plague and cholera;
• herpes;
• a group of cardiovascular abnormalities such as hypertension, heart attack, ischemia, angina pectoris;
• oncological diseases;
• diphtheria and tetanus;
• tuberculosis of any localization;
• typhus, foot-and-mouth disease and anthrax;
• botulism, dysentery and salmonellosis;
• tick-borne encephalitis;
• sepsis.

Separately, there is a list of more rare diseases, some of which are recorded literally in isolated cases. Thanks to the coordinated work aimed at prevention.

Diagnostic methods

Depending on the current suspicions regarding the disease, not only laboratory tests, but also diagnostic tests will be prescribed. The latter require the use of specialized equipment. Moreover, it can be located both in the laboratory itself, where testing is carried out, and in the diagnostic room. Even the simplest ECG device is a representative of the category of such equipment, because with its help it will be possible to establish deviations in the work of the heart muscle.

If there is a suspicion regarding the development of an infectious effect on the body, then the technique is most often used bacteriological research by the method of crops on certain media, or bacterioscopy under a microscope after staining. For this, the following materials are collected:

• blood;
• urine;
• saliva;
• sputum.

Sometimes material is required, which is obtained during certain examinations. This applies to the diagnosis of complex diseases such as pulmonary tuberculosis. One x-ray and sputum results may not be enough. To eliminate all risks, the patient is sent for bronchoscopy in order to make a sample from the bronchial environment using a special apparatus. Such wash waters are investigated according to the principle similar to other materials. Of these, crops are made for certain environments.

Processing time for material samples may vary depending on the specific need, but usually 7-10 days is sufficient. According to the final result, bacteria or fungi can be detected, if they took place at all.

Much more time has to be spent if it is necessary to establish an indicator of sensitivity to antibiotics and phages of bacteria or other pathogens. But such a long wait will allow you to adjust the effective therapy. During treatment, only effective medicines so as not to expose the body to an unnecessary toxic load, because many medicines have side effects.

IFA is considered another weapon. This is the abbreviation for Method. enzyme immunoassay blood. With its help, it turns out to speed up the receipt of results, and not wait for weeks, as bacteriological seeding suggests.

And the last word in science was the PCR test, which detects the DNA of alleged pathogens. It is likely that even more productive methods will soon appear that will save thousands of patients.

> Epidemiologist

This information cannot be used for self-treatment!
Be sure to consult with a specialist!

What problems does the epidemiologist solve?

An epidemiologist is a specialist with a higher medical education. Its competence is to conduct epidemiological surveys of foci of infectious diseases, analyze the epidemiological situation, plan and implement anti-epidemic measures and, most importantly, monitor compliance with the sanitary and epidemiological regime on the ground.

Where do these specialists work and with whom do they work?

Epidemiologists work closely with microbiologists, bacteriologists, virologists, pediatricians, infectious disease specialists. The main place of work for epidemiologists is sanitary and epidemiological stations (SES). Some of them work in research laboratories and institutes.

The SES epidemiologist builds his work in accordance with the action plan to reduce the level of infectious disease. In its activities, it is guided by the Orders of the Ministry of Health, approved instructions and regulations, maintains control and accounting documentation.

The specifics of the work of epidemiologists

The activity of an epidemiologist includes the organization and implementation of a set of regulated measures directly in the focus of an infectious disease: establishing the source of infection, determining the epidemiological history, determining the circle of contact persons, developing and implementing anti-epidemic measures, including quarantine. Most often, the epidemiologist himself pays a visit to the patient and finds out the details of the disease. To determine the source of infection, the SES worker conducts sampling in the outbreak (washouts from various surfaces and hands, food, water, etc.). The duties of the epidemiologist include the organization of the final disinfection in it.

What are the challenges facing these physicians?

All medical institutions, schools and kindergartens, health camps, catering establishments, food industry facilities are under the vigilant control of the territorial SES. Regular visits by epidemiologists to these and many other institutions are carried out in order to verify compliance with the anti-epidemic regime and established sanitary and hygienic standards. The ultimate goal of such strict control is to prevent outbreaks of infectious diseases, and if cases of the disease are already registered, to prevent its spread.

The epidemiologist analyzes daily information about violations of the sanitary and hygienic regime, cases of infectious diseases and atypical reactions to the introduction of vaccines.