FEM-WIKI

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Welcome to FEMWIKI

The Field Epidemiology Manual was originally developed by the ECDC to support the European Programme for Intervention Epidemiology Training (EPIET). Trainers, supervisors, scientific coordinators, and facilitators created draft chapters using the lectures they delivered during the EPIET introductory course. The philosophy of sharing and building knowledge (in particular training materials) led to the creation of a collaborative information space for the epidemiological training community - The FEM Wiki.

Eventually, the ECDC decommissioned the FEM Wiki and archived the last version as a PDF. Since FEM Wiki content was developed under Creative Commons, the Dutch Public Health Learning Support Company Transmissible decided to reinstall the Field Epidemiology manual as it was intended: a professional collaborative platform.

The aim of the FEM Wiki is to create a library of training materials for field epidemiology training programs.


Article Portal

Assessing the burden of disease and risk assessment 

Descriptive data analysis Analysis by person characteristics Analysis by place characteristics Choosing an appropriate type of map Which indicator to map?

Analysis by time characteristics Methods for setting thresholds in time series analysis Smoothing techniques for describing time series

Spatial Analysis (Geographical Information Systems)

Epidemic Intelligence Rapid Risk Assessment Classifying and Measuring Risk Identifying Risk Stage 0: Preparation for rapid risk assessment Stage 1: Collecting event information Stage 2: Systematically collecting information Stage 3: Extracting relevant evidence Stage 4: Appraising evidence Stage 5; Estimating the risk

Surveillance - Principles Criteria for Surveillance Event-based Surveillance Indicator-based Surveillance Establishing a Surveillance System Analysis of Surveillance Data Analysis, Interpretation and Dissemination Quality checking

Common errors in surveillance data analysis Evaluation of Surveillance Systems 10 common errors in surveillance evaluations Quality, Governance and Operating Procedures Surveillance attributes for evaluation capture-recapture


Sources and Types of Data Types of Surveillance System (Active vs Passive) Surveillance System Design and Operation


Uses of Surveillance Data

Objectives of Surveillance – Inputs and Outputs Opportunities and Challenges Surveillance or Research? The Components of Surveillance The Role of Surveillance


Field Epidemiology Combining Studies: Meta-Analysis Key definitions in infectious diseases epidemiology Measurement in Field Epidemiology Cluster Investigations Statistical Methods for Cluster Investigation Types of Cluster

Getting Measurement Right Measures of association Measures of Disease Impact Impact numbers Measures of disease impact - Further reading Measures of impact among the exposed Measures of impact in the population Quantifying disease burden

Measures of Disease Occurrence Attack rates and case fatality Incidence rate Odds Probability

Prevalence Relation between risk and incidence rate Risks and Rates

Problems with Measurement Bias Detection Bias Effect Modification and Confounding Confounding in studies Criteria for confounding Dose Effect Effect Modification Interaction Residual Confounding

Information (Measurement) Bias Interviewer Bias Recall Bias Reporting Bias Response Bias

Preventing bias Selection Bias Selection bias and case-control studies Ascertainment Bias Diagnostic bias Non-response bias Referral bias Survival bias

Selection bias and cohort studies


Testing the Tests Diagnostic tests versus screening tests Glossary Parallel versus Serial testing Receiver operating curve Test Precision Test reliability Test Reproducibility Threshold setting Validity and accuracy


Methods in Field Epidemiology Scientific (evidence base for prevention) Causal Inference Causal mechanisms Viewpoints for Causality (Bradford Hill)


Types of Study Analytical Study Designs Advantages and disadvantages of cohort and case control studies Case-control studies Case-cohort study Density case control studies Table measuring risk, rate and odds ratio Traditional case-control studies

Choosing a Reference Group Control Selection Developing a control definition Special Considerations in Control Selection

Cohort studies Measuring incidence rates Measuring risk Reference group for cohort studies

Cross-sectional Studies Matching Advantages and disadvantages of matching Principles of matching Restriction Table format and Analysis

Measures of effect in various study designs Non-traditional designs Case cross over studies Case to case study design


Descriptive Studies Experimental Studies


Outbreak Investigations Case definitions for outbreak assessment Case Definitions Defining a Case Sensitivity and Specificity of a case definition Various Levels of Case Definition


Confirm the outbreak Types of Outbreak Continuing Source Distinguishing Different Sources or Modes of Transmission during an outbreak Identifying Multiple Possible Outbreak Sources Person to Person Point Source Refining the estimated point in time of an outbreak source Incubation period, Latent period and Generation time.

Unmasking Outbreak Source through Segmentation Vector Borne


Describe the outbreak Construction of Epidemic Curves Diagnostic Applications of the Epidemic Curve Disentangling Complex Data Use of Epidemic Curves for characterising Outbreak Sources


Informing Action / Improving Knowledge Additional resources for presenting findings Choosing a method of data display Communication of findings To professionals Definition of an Outbreak Investigation Report Frequent Problems with writing an Outbreak Investigation Report Structure of an Outbreak Investigation Report Writing an Outbreak Investigation Report Writing style of an Outbreak Investigation Report SOCO (single over-riding communications objective)


To Public and the Media

Graphs, charts, diagrams Bar graphs Frequency polygons Histograms Line graphs Other types of data display Pie charts

Interpreting Data Maps Presenting Data Tables Types of variables and line listing Use of computers

Investigations in Special Circumstances Disasters and Emergencies Health care settings Possible Terrorist / Deliberate Event Prisons Schools

Outbreak investigations: 10 steps, 10 pitfalls Outbreak steps : additional points Rationale for Outbreak Investigations Public health response (informing control)

The outbreak management team


Formal Risk Assessment Health Economics Cost-effectiveness Cost-minimisation Cost-utility Measuring the Quality of Healthcare Sensitivity Analysis

Screening Evaluation of Screening Measures of Accuracy in Screening Principles of Screening


General Communication Aide memoire for oral presentations and visual aids Health communication Crisis communication Health advocacy Health education Health literacy Outbreak communication Risk communication Social marketing

Writing a Study Protocol Analysing a public health problem SMART definitions

Checklist for study protocols Data collection instrument Questionnaire Design Advantages and Disadvantages of Questionnaires Bias in Questionnaires Hints to Design a Good Questionnaire Questionnaire Layout and Coding Seven Golden Rules to Design Questions

Piloting Questionnaires Ten Steps to Design a Questionnaire Types of Questionnaires Types of Questions Format of closed questions

Validated questionnaires


Writing for Publications Checklist for posters Scientific paper review form

Writing for Stakeholders

Infection control and hospital hygiene Antimicrobial stewardship Healthcare-associated infection prevention and control as a part of patient safety programme Healthcare-associated infection prevention and control programme Cooperative learning as active learning in adult Education and training of staff

Healthcare-associated infections and risk assessment Burden of HAIs Main pathogens and resistance Antimicrobial resistance. Acquired resistance Mechanisms of antimicrobial resistance

Multidrug-resistant organisms (MDRO)

Types of HAIs CAUTI CLABSI SSI VAP


Infection control interventions Cohorting patients and/or staff Contact precautions Developing infection control interventions: isolation Environment as a source of healthcare-associated infections Hand hygiene Gloves and hand hygiene Hand hygiene - principles Five moments for hand hygiene Hand hygiene before invasive procedures Hand hygiene for patients and visitors Indications for hand hygiene

Hand hygiene education and promotion Hand hygiene methods Hand hygiene products selection and evaluation Aesthetic preferences Evaluation of the microbicidal activities of hand-rub and hand-wash agents Pilot testing Product accessibility and cost Selection and evaluation for specific products

Microbial flora of the hands Nails, rings, watches, bracelets Skin care

Hospital cleaning and decontamination Immunization of health care workers Isolation of patients with Clostridium difficile infection (CDI) Methods for assessing environmental cleanliness Microbial typing Molecular epidemiology Pre-emptive isolation Reprocessing of flexible endoscopes Standard precautions The role of the clinical microbiology laboratory in infection prevention and control Clinical role of the microbiology laboratory. Epidemiological/public health role of the clinical microbiology laboratory


Surveillance and investigation of healthcare-associated infections Case definitions of healthcare infections HAI case definitions for use in hospitals Bloodstream Infection Bone and Joint Infection Cardiovascular System Infection Catheter-Related Infection Central Nervous System Infection Eye, Ear, Nose or Mouth Infection Gastrointestinal System Infections Lower Respiratory Tract Infection other than pneumonia Pneumonia Reproductive Tract Infections Skin and Soft Tissue Infections Specific Neonatal Case definitions Surgical Site Infection Systemic Infections Urinary Tract Infection


European surveillance of healthcare-associated infections ECDC point prevalence survey of healthcare-associated infections and antimicrobial use in acute care hospitals ECDC “Point prevalence survey of healthcare associated infections and antimicrobial use in European acute care hospitals” protocol ECDC “Point prevalence survey of healthcare associated infections and antimicrobial use in European acute care hospitals”, definition of healthcare-associated infection ECDC PPS - antimicrobial use definition ECDC PPS - inclusion/exclusion criteria


ECDC point prevalence survey of healthcare-associated infections and antimicrobial use in long term care facilities ECDC surveillance of Surgical Site Infections HAI Surveillance at the EU level - importance of international networks ECDC Programme on antimicrobial resistance and healthcare-associated infections European Antimicrobial Resistance Surveillance Network (EARS-Net) European Surveillance of Antimicrobial Consumption Network (ESAC-Net) Healthcare-Associated Infections Network (HAI-Net)

Surveillance of Clostridium difficile infections Surveillance of HAIs in intensive care units The European Surveillance System (TESSy)

Surveillance of healthcare-associated infections - definition Surveillance methodologies for healthcare associated infections

Surveillance of healthcare-associated infections - other approaches Surveillance for MV Patients in the ICU


Introduction to Public Health and basic concepts Public Health Informatics Apps for epidemiologists Data Capture Systems Electronic Data Transfer Online Reporting Web-crawling Applications

Health Informatics Standards – general introduction Health Informatics Standards - Health Information Systems and Processes Health Informatics Standards - Standard Content

Software for epidemiologists Weblinks for epidemiologists

Public Health Interventions Contact tracing Host Prevention Hygiene and Sanitation Primary prevention Vaccination Herd immunity Measuring protection


Secondary prevention Tertiary prevention

Reservoir for infectious agents Source of infection Transmission routes

Public Health Law Brief history of International Communicable Disease Law EU Public Health Legislation Decision 1082/2013/EU: Serious cross border health threat Some key recitals under 1082

EU Food Safety Legislation EU Legislation for Communicable Diseases Surveillance

International Health Regulations 2005 edition Applying Epidemiology for the International Health Regulations.


Public Health Microbiology Applied Immunology Antibodies Antigen presenting cells (APC) Antigens (Ag) How pathogens try to trick our defenses Helminthic mechanisms of immune evasion

Mechanism of infectious disease What determines our susceptibility to infections?

Practical Aspects of Specimen Collection and Shipment The Role of Microbiology Bioinformatics Expert Advice Laboratory Support

Types of Microorganisms

Public Health Programs

Statistical Concepts Models Logistic Regression Estimating Odds Ratios in the presence of interaction Fitting logistic regression models Interpreting model coefficients Linear models Model building strategies The logistic model

Stratified Analysis The Mantel Haenszel Method


Power and Sample Size Presenting Statistics Sampling Concepts in sampling

Statistical Tests Significance and Confidence Confidence Intervals Significant probability to be different from the expected The idea of Statistical Inference

Contributors