Epidemiology technologies
ASSIGNMENT INSTRUCTIONS
You are a new employee at your state public health department. Your organization has been given a federal grant develop a public health surveillance program. You need to develop a public health surveillance program that incorporates technology. Do some research on public health surveillance programs. Do some research on new technologies that can be used for public health surveillance. Your recommendations should be based off of research and should incorporate the use of low cost and readily available technologies.
You must describe your approach using multiple CONCEPTS and TERMS from the textbooks (10 minimum) CHAPTERS 1-15. You must also use a minimum of 18 additional different articles or books as references along with your textbooks. This paper is to be written in APA format and must have in-text citations (References embedded in your paragraphs) –
Your paper should have all the following: -An introduction that explains what is happening in the case. -A problem statement that states the most significant problem. -A literature review that outlines terms, concepts, and theories from the course texts that can explain that dynamics of the situation, impacts of the situation, and potential consequences of the situation. -Find articles that allow you to come up with 5 or 10 recommendations on how to address this issue. *YOU SHOULD NOT WRITE THIS PAPER FROM THE PERSPECTIVE OF \’I\”
*Textbook provided in the attachment. (Links below can help:) Link 1 https://www.cdc.gov/training/publichealth101/surveillance.html (Links to an external site.) Link 2 https://www.cdc.gov/surveillance/pdfs/Surveillance-Series-Bookleth.pdf (Links to an external site.) Link 3 https://www.cdc.gov/globalhealth/healthprotection/fieldupdates/fall-2018/smartphones-connect-data.html (Links to an external site.) Link 4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245630/ (Links to an external site.) Link 5 https://www.ncbi.nlm.nih.gov/books/NBK11770/ (Links to an external site.) Link 6 https://www.who.int/immunization/monitoring_surveillance/burden/VPDs/en/ (Links to an external site.) Link 7 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2971522/ (Links to an external site.) Link 8 https://www.himss.org/resources/wearable-technology-applications-healthcare-literature-review (Links to an external site.) Link 9 http://www.wvdhhr.org/idep/pdfs/idep/lesson5.pdf (Links to an external site.) Link 10 https://www.annualreviews.org/doi/full/10.1146/annurev-publhealth-040119-094402 (Links to an external site.) Link 11 https://www.cdc.gov/globalhealth/healthprotection/fieldupdates/fall-2018/smartphones-connect-data.html (Links to an external site.) Link 12 https://www.nature.com/articles/s41467-020-18190-5 (Links to an external site.) Link 13 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7263257/ (Links to an external site.) Link 14 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275133/ (Links to an external site.) Link 15 https://www.npjournal.org/article/S1555-4155(18)31275-3/pdf (Links to an external site.) Link 16 https://ascopubs.org/doi/full/10.1200/EDBK_238919 (Links to an external site.) Link 17 https://www.jmir.org/2019/9/e14017/ (Links to an external site.)
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SAMPLE ANSWER
Introduction
Influenza is among the significant health challenges that affect the United States and other countries at large (Friss, 2009). It has been categorized as among the leading cause of death in the U.S (Tenforde et al., 2021). It results in huge morbidity, mortality, and stress the hospital resources while it is increased in circulation. According to Tenforde et al. (2021), there was an estimation of 410000 to 740000 influenza hospitalization cases and 24000 to 620000 influenza-related deaths in the U.S. during the influenza breakout period in 2019-2020. Most of the adults infected with influenza are often older and at risk of persistent medical ailments (Tenforde et al., 2021). They may sustain sepsis, respiratory failure, and ischemic coronary attacks. Sometimes influenza is referred to as the flu.
There are various variants of influenza, including avian influenza (bird flu) which is caused by the H5NI and first appeared in the late 1990s (Friss, 2009). Other types include influenza viruses A, B, C, and D. The human influenza A and B viruses result in seasonal epidemics that are common during the winter season in the U.S (CDC, 2019). One influenza A(H1N1), A(H3N2), and one or two influenza B viruses are often included in every season’s influenza vaccine. According to Chow, Doyle & Uyeki (2019), it is recommended for all individuals in the U.S. above six months get an annual influenza vaccination.
According to CDC (2019), getting an influenza vaccination minimizes the risks of severe illnesses that require hospitalization, ICU admission, or even death. However, it is imperative to note that seasonal flu vaccines hardly protect against influenza C or D viruses (CDC, 2019). There are numerous viruses besides influenza that might result in influenza-like ailments which proliferate during the flu season. Due to these variations, the treatment costs and vaccinations are generally high and almost cost the U.S. government over eighty billion for the disease each year (CDC, 2019). These high prices put a strain on the economy and the communities at risk. This paper looks into influenza as an infectious disease and its burden to public health efforts.
Problem statement
Influenza virus often happens in outbreaks and epidemics across the globe, especially in winter (WHO, 2018). It varies in intensity and extension each year. Influenza’s epidemiological patterns are based on several factors including the changing nature of the virus’s antigenic properties, the virus’s transmissibility power, and the population’s susceptibility. Influenza virus tends to attack young people at a higher rate; however, it is the older adults that repost a higher mortality rate (Tenforde et al., 2021). The mortality and morbidity rate are especially high among older adults with metabolic ailments, cardiovascular illnesses, and advanced age. However, measuring the influenza virus-related burden of illnesses is a difficult challenge. Influenza A and B viruses tend to result in febrile diseases, but most of the resulting mortality and morbidity is a result of the complications that secondary infections bring (CDC, 2021).
According to Groseclose, & Buckeridge (2017), the primary objective of the influenza virus surveillance public health program will be to observe the inception, denote the epidemiology and clinical burden of influenza viruses. Another objective is establishing the morbidity and mortality burden that results from the influenza viruses and aid in offering substantial decisions while formulating the surveillance programs (Groseclose & Buckeridge, 2017). It is because these surveillance programs will assist in spearheading immunization activities that will enhance to coverage of current influenza vaccines while adding new influenza vaccines.

Literature Review
Signs and symptoms
Influenza illness is linked with various signs and symptoms. According to Moghadami (2017), it customarily begins with a sudden onset of high-grade fever, headache, malaise, and myalgia. These symptoms are later accompanied by nonproductive cough, nasal discharge, and sore throat (Moghadami, 2017). Influenza affects the heart, brain, and lungs. Its adverse effects are in the respiratory tract which leads to hospitalization. The influenza virus takes a mean of 5 to 10 days to begin shedding in the immunocompetent adult patients (CDC, 2021). It takes a maximum of two weeks for patients to recover from the disease.
Clinical manifestations
According to CDC (2021), Influenza starts with sudden symptoms with follows an incubation period of 1 to 2 days. Influenza could manifest in respiratory ailments similar to the common cold to illness which signs and symptoms predominate with little respiratory tract infection signs (CDC, 2021). It leads to gastrointestinal signs such as nausea, diarrhea, and vomiting in the initial days (Ghebrehewet, MacPherson & Ho, 2016). The influenza patient has a high-grade fever and it begins to dimmish from the 2nd to 3rd day (CDC, 2021). The patient’s face can be watery and red-eyed during the initial course of the disease followed by a period of dry cough and malaise.
Influenza complications lead to pneumonia. The primary influenza viral pneumonia happens among people with heart diseases or any underlying pulmonary illnesses like asthma (CDC, 2021). The influenza virus also affects the musculoskeletal system. According to Ghebrehewet et al. (2016), influenza cases become diagnosed clinically in the population or where the virus is known to be prevalent. Admitted hospital patients might have their respiratory samples taken for testing (Ghebrehewet et al., 2016). The respiratory outbreak can occur in an enclosed setup and nasal swabs may be acquired from the earliest few symptomatic people to know the accountable organism.
Mode of transmission
Influenza illness is thought to be transmitted via close contact with a person who contracted the illness (CDC, 2021). It is because this virus is mainly transmitted through cough droplets. Having proximity with an infected person escalate the possibility of contracting it (CDC, 2021). The virus can get transmitted through touching surfaces that are not disinfected. According to CDC (2021), when a non-infected person touches the contaminated surface and proceeds to touch their face with the same hands, they risk getting infected with the influenza virus.
Prevention of influenza transmission
Healthcare workers need to remain vigilant and protect themselves against the spread of the influenza vaccine within the healthcare setup (Dini et al., 2018). The core prevention techniques include acquiring an influenza vaccine, maintaining respiratory hygiene and cough etiquette, and adhering to the infection control precautions for all patient-care activities (CDC, 2021). The healthcare workers and the population at large need to implement environmental and engineer infection control measures. Another way to prevent contracting the illness is through using caution while performing aerosol-generating processes (CDC, 2021). It is essential to monitor influenza activity by checking on the influenza activities as reported by the local and state authorities and adhering to the laid-out protocols.
The dynamics of the influenza virus
Despite the decades of surveillance, pharmaceutical and non-pharmaceutical interventions to curb the influenza virus, it remains a great epidemic across the globe each year (Petrova & Russell, 2018). According to Petrova & Russell (2018), the seasonal influenza virus continues to infect five to fifteen percent of the human population yearly. It results in more than 500000 deaths across the globe (Petrova & Russell, 2018). A single vaccination of the virus is not enough, and the vaccines need to be updated yearly to keep pace with the changing evolution of the circulating influenza virus.
The re-emerging infectious illnesses such as the pandemic influenza occurs via a significant antigenic change of the influenza virus. It majorly originates from different hosts including the swine and birds (Furuse & Oshitani, 2016). Over the years, the pandemic influenza has replaced the disseminating seasonal influenza virus. According to Furuse & Oshitani (2016), the emergence of the swine-flue HINI pandemic in 2009 is closely linked to the virus that resulted in the Spanish flue of 1918. The influenza pandemics are an imminent threat to the human health population (Furuse & Oshitani, 2016). Seasonal influenza results in annual epidemics as they evade herd immunity. According to Furuse & Oshitani (2016), the virus could be imported from country to country and continue to mutate thus being somewhat challenging to eradicate.
There are three influenza viruses currently co-circulating the human population and causing major health havoc. According to Yang et al. (2020), the A(HINI), A(H3N3), and type B influenza viruses are continuously evolving and the ecological interactions shape the transmission dynamics. The infection of a particular type or strain across the subtypes can result in partial immunity to the influenza strain of a similar type (Yang, et al., 2020). The cross-reactive immunity leads to an epidemiological interaction among the influenza viruses and they shape the phylodynamic and epidemic dynamics.
According to Mousa (2017), the human respiratory tract hosts various viruses’ communities that co-circulate in space and time and this forms the ecological niche. Influenza virus attacks the host’s immune control efficacy. It leads to various injuries including dynamic inflammation and lung inflicted injuries. It links the between vital pathogen kinetics and the host pathology which increases the disease progression, and potential complications (Mousa, 2017). During the IAV infection in animals and human beings, the viral load increases swiftly for the first one or two days of infection before arriving at the peak (Mousa, 2017). When the host had no previous immunity, the viral loads in their lungs starts to decline slowly then quickly. The influenza virus keeps recurring due to the unavailability of efficient treatment or vaccines (Mousa, 2017). The unavailability of optimal medication and timely vaccines makes the illness progress within the body, and that’s why people result to natural therapies to assist in combating respiratory infections including influenza.
Demographic information
Morbidity and mortality
The 2019-2020 influenza season in the U.S. was severe despite the minimal A(H3N2) activity. Tenforde et al (2020) state that during this season, children were heavily affected, and from February 2020 onwards the influenza A(H1N1) predominated the adults. There were over 16.5 million hospitalization cases and more than 490600 patients got diagnosed with influenza signs and symptoms (Tenforde et al., 2020). According to WHO (2018), seasonal influenza infects up to 20% of the human population depending on the circulating virus.
Impacts of the influenza situation,
Influenza disease burden is considerable, especially among young kids, older adults, and people with underlying ailment conditions (CDC, 2021). The impact of influenza virus wreck-havoc across the globe with increased hospitalization and death-related illnesses (Lafond et al, 2021). The virus has resulted in various recommendations by the WHO strategic advisory group of experts on influenza vaccination programs. These programs target pregnant women, people with high-risk conditions, children below 59 months, and healthcare workers (Lafond et al., 2021). According to Lafond et al (2021), the SAGE released an interim recommendation prioritizing the healthcare workers and older people for the influenza vaccination.
Influenza virus results in a global pandemic that affects people across all ages. It results in a great challenge while estimating the burden of the illness to the population (Lafond et al., 2021).
It is often challenging to distinguish the influenza virus from other respiratory illnesses without proper lab testing. According to Lafond et al (2021), there is incomplete and low-quality surveillance data from which the influenza virus estimates are made.
Potential consequences of the influenza situation
Influenza virus has adverse consequences to the patients and the entire population at large. According to Chen et al (2017), patients who live to survive this illness are at great risk of psychological and physical complications to their lungs. They are also at risk of multi-organ dysfunction. The new influenza A(H7NP) virus was isolated from an epidemiologically linked poultry market (Chen et al., 2017). The virus causes deadly illnesses in people who come into contact with poultry, including acute respiratory distress syndrome and pneumonia. According to Chen et al (2017,) the survivors of the virus have lung injury due to the diffusion of alveolar.
The influenza illness puts a strain on the economic burden. Prevention and treatment of this illness are characterized by high costs and a strain on the hospital resources (Moghadami. 2017). The healthcare practitioners affected with the illnesses while attending to patients lead to productivity loss (Dini et al., 2018). It leads to psychological torture to people either infected or affected by the ailment.
Acute respiratory illnesses including those caused by influenza viruses can worsen the asthmatic patient’s condition. Acute influenza results in the decompensations of patients suffering from congestive cardiovascular illnesses or diabetes mellitus (Gordon & Reingold, 2018). It can also cause acute otitis media and is linked with an increased risk of Guillain-Barre syndrome.
Research on public health surveillance programs.
The influenza surveillance programs are vital in collecting, compiling, and analyzing information on influenza activity yearly (Groseclose, & Buckeridge, 2017). It enables a profound exploration of the influenza surveillance data to get insights into combating this predicament. According to CDC (2021), The influenza surveillance system is a collaborative effort between CDC and many partners in the public health, clinical labs, and other long-term care facilities.
The influenza viruses result in acute infections in the upper and lower respiratory tracks (CDC, 2021). These illnesses are later subdivided for the influenza surveillance programs to estimate the burden of the problem and check out for any severe acute respiratory infections (CDC, 2021). The surveillance program team’s role is to assess the weight of influenza virus illness and test out specimens from patients with influenza-like diseases and severe acute respiratory illness (Gordon & Reingold, 2018). The team follows various individuals for some to form a clinical trial or a cohort study thus making it possible to calculate the influenza incidence. It provides a ground to begin testing the population and giving substantial figures to the public health sector on the advancement of the influenza virus. According to Gordon & Reingold (2018), testing people for influenza virus can assist in determining the prevalence of influenza-associated diseases and mortality rate.

According to Groseclose, & Buckeridge, (2017), the surveillance programs are vital in offering data regarding the medically attended diseases proportions. With the right technology, the influenza surveillance systems can detect the presentation of influenza virus infections that do not meet the surveillance definition such as afebrile.
Maintaining a detailed influenza surveillance system is essential in monitoring the constantly changing antigenic drift of influenza viruses Groseclose, & Buckeridge, 2017). It offers a chance to collect and characterize the emerging viruses and develop the required vaccines. The surveillance of influenza viruses assists in detecting the changes and informing the public health response and administering vaccines based on the surveillance findings (Groseclose & Buckeridge, 2017). It also helps in treating the influenza virus infection as directed by the lad surveillance for antiviral resistance (CDC, 2021). The influenza virus surveillance and other targeted research studies monitor influenza impact on various population segments and record updated findings that will assist in distributing the public health resources.
Forming an influenza surveillance program helps in implementing practical ideas that will assist in controlling the spread and severity of the influenza epidemic episodes (CDC, 2021). It will ensure that the vaccine manufacturers have the right information while formulating the influenza vaccines. According to CDC (2021), Influenza surveillance programs include various people such as patients of all ages in schools, nursing homes, military recruits, and experts from the public health service.
Including health practitioners in the influenza virus surveillance program assists in acquiring samples from the patients that become hospitalized with influenza virus symptoms (Puni et al., 2018). The health practitioners assist in getting swift identification of the causative agents and collection of data. According to CDC (2021), The surveillance programs assist in the practical conditions such as home care activities on patients suffering from influenza virus, the practitioner activity level, and the drugs intake to lessen the severity of the virus.
The surveillance program team will assist in determining the social factors associated with the spread of the influenza illness (Groseclose, & Buckeridge, 2017. It will make it easier to have a care report that will aid public health practitioners to find the best preventive measures while combating the influenza pandemic. It will assist the medicine manufacturers in developing ideal vaccines that can help in combating the spread of the influenza vaccine during its peak season (WHO, 2018).
Research on new technologies that can be used for public health surveillance
According to Rockman, Laurie, Parkes, Wheatley & Barr (2020), Influenza vaccination is the ideal approach to preventing the infection of the virus. The approach has better safety profiles, acceptable tolerability, and moderate efficacy. Vaccines induce protective immunity via the antibodies to the viral protein surface (Rockman et al., 2020). However, it is vital to note that an antigenic drift can occur. The influenza virus can circumvent all the ongoing vaccine-induced immunity by accumulating the mutations of the proteins and modifying the antigenic properties. It results in the escaping recognition of the virus-induced antibodies (Rockman et al, 2020). It is essential to note that the immunological imprinting that follows the initial influenza infections in childhood might impact the influenza vaccine’s effectiveness via altering the immune response to the vaccine introduced later in life. However, the introduction of new technologies assists in overcoming the different shortcomings such as antigenic drift, unwanted egg adaptations, and poorly immunogenic antibody responses (Rockman et al., 2020).
Embracing new technologies in the influenza surveillance programs will assist in increasing human protection against the seasonal influenza pandemic. It will ensure that all the participants also remain safe while studying and conducting on-the-ground investigations of the influenza virus (Rockman et al., 2020). Adopting the new technologies will assist the surveillance program in making great improvements that will ultimately lead to an efficient universal influenza vaccine.
The first new technology that the surveillance team can adopt is nucleic acid technology. It is an attractive vaccine approach that has consistency in the production and formulation of the vaccine. According to Rockman et al. (2020), this technology the manufacturers can target antigens by changing the encoding sequence of the antigens that can be used in the vaccine. The nucleic-acid technology eases the production of the influenza vaccine and ensures the vaccine is top-notch which adapts to encode the different antigens. The technology reduces the risk of the adventitious agency.
The RNA technology could also be beneficial to the surveillance program to assist in developing a better way to respond to the seasonal influenza pandemic. The influenza H3N2 virus is predicated to be deadly than the flu pandemic season in 1968 (Rockman et al., 2020). Adopting a new RNA vaccine technology could increase an effective influenza vaccine shot. It could speed the vaccines’ manufacturing procedure by eliminating the multiple guesswork of matching the ideal formulation to the season’s dominant strains (Rockman et al., 2020). The RNA technology is easier and the equipment used could make bulk vaccines at a go. The technology includes a non-replicating m-RNA and in vivo self-replicating approach (Rockman et al., 2020). The RNA technology offers public health officials and scientists a chance to respond to the influenza vaccine pandemic quickly and assess the various virus strains to attain an effective vaccine and save lives.
According to Rockman et al (2020), DNA vaccination technology could be effective in preventing influenza. The DNA vaccines are based on direct injection of the DNA to protect from the homologous and heterologous challenge respectfully. However, this new technology has a setback as it might result in the degradation of DNA by host enzymes, thus requiring a large dose of DNA to be used on humans (Rockman et al., 2020).
Another genetic data technology that can be used in combating the influenza virus is the live attenuated influenza vaccine technologies (WHO, Fact Sheet, 2018). Through technology, it creases vaccines gotten from cold-adapted and attenuated influenza virus (WHO, Fact Sheet, 2018). They are administered intranasally and stimulate the immune response. However, minimal data is supporting the usage of the live attenuated influenza vaccine. The insufficient data supports its expansion due to safety concerns, especially on people with chronic illnesses.
Conclusion
Influenza poses a huge threat to public health and national security. Seasonal influenza results in numerous hospitalization cases and deaths as people have little or no immunity when the virus emerges. There is a need to think about ways to reduce influenza virus morbidity and mortality and ensure that it does not put a strain on the economy. It is imperative to reduce the severity of the influenza virus while saving lives and responding to the seasonal epidemics and potential pandemic that this disease possess. Forming surveillance program teams enables manufacturers to get the right data about the illness and focus beyond producing seasonal vaccines. It is a chance to rely on flexibility while responding to the emergence of the virus. It is vital to note that any delay in detecting the influenza virus could result in a considerable rise in morbidity and mortality. The surveillance program’s role assists in minimizing significant gaps such as insufficiencies in domestic vaccine production and provides information that will assist in producing optimal vaccines that are effective and keep the rising cases of influenza to the minimum.
Recommendations
Implementing new technologies to fight off the influenza virus will assist in boosting the potency and epitope selectivity of humoral responses (Rockman et al., 2020). It will aid in performing better clinical trials on influenza disease and ensure that the vaccines are developed in due time. Embracing new technologies allows for better research on the possible roles of herbal supplements and therapies in preventing respiratory viral infections such as intractable influenza. Adapting new technologies ensures that there is effective molecular testing in hospitalized patients (Plun-Favreau et al., 2016). It ensures there is easier antigen detection among people and gets proper information on clinical choices. Usage of new technologies will ensure that public health practitioners acquire accurate data required for optimal dosage and therapy duration with neuraminidase inhibitors to severely ill influenza patients. When the public surveillance health program team adopts new technology to collect data, they can offer timely data for the intravenous peramivir within patients who are critically ill from the influenza virus. Another recommendation is research expansion on the safety of live attenuated influenza vaccine in individuals with a history of diabetes mellitus, asthma, or any other high-risk medical conditions (Bandell et al., 2021).
Recommendation on the usage of RNA technology will ensure timing vaccination and curb the circulation of influenza vaccine, especially during its peak season (Rockman et al., 2020). Forecasting the inception, span, or intensity of the influenza vaccine is only possible through the usage of nuclear technology. It will assist in finding the balance between the health strategies required in achieving considerable vaccination coverage while achieving optimal individual immunity. It will ensure that the public health sector can initiate influenza vaccination before the influenza virus begins to circulate within the communities. Another recommendation is a partnership among various public health surveillance programs in embracing health information technology standards (CDC, 2021). It will help in the execution of influenza and other disease vaccine guidance in computerized systems and top-notch measurement attempts. It will be facilitating the coding of the data and thus predict the nature of the virus with ease. Collaborating with other public health agencies will ensure an effective strategy, vaccine planning and distribution, ongoing influenza activity communication, and timely administration of the influenza vaccine (CDC, 2021). It will ensure that the healthcare system does not become strained and that the health care practitioners are safe from the influenza virus. It will assist people in conducting their works without straining the local and state budget in channeling a lot of cash towards treating the illness. Their focus will be looking at the best preventive measures that people can adopt.
Reference
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Terms and concepts used
Influenza- an infectious disease that causes mortality and morbidity in the United States and across the globe.
Avian influenza- is a type of influenza caused by the H5N1 virus.
Pandemic – it is a health crisis that manifests globally across various international boundaries.
Vaccination – the method in which a vaccine is introduced into the body to ensure it has the ideal immunity against a virus or bacteria.
Morbidity – development of an ailment in a population
Mortality – death occurring on a large scale in a population
Surveillance – accurate collection, analysis, and interpretation of consolidated data concerning the development of a particular illness within the population.
Infectious disease – an ailment due to an infectious agent
Re-emerging infectious disease – an infectious illness that keeps reappearing within a population and continues to increase in a population or geographic range rapidly.
Public health surveillance is the structured and continuous information gathering about the development of an ailment and other health crises.
Population – all the inhabitants of a given geographical location, considered together
Cohort – a population segment or a subset of a group that is set aside by monotonous characteristic and is followed over time; for example, age cohort
Cohort study – tracks the occurrence of a particular illness and other outcomes over a period.
DNA – the deoxyribonucleic acid is found within the human body cells and most organisms as it carries the organism’s genetic information.
Epidemiology- is concerned with the distribution and health and illness determinants, injuries, morbidity, disability, and mortality of populations. The epidemiologic studies are applied to the controls of health challenges in a population.
Herd immunity – an instance where the whole population becomes resistant to an infectious illness because of the immunity of the large proportion of people in that population to the illness.
Prevalence- the number of existing disease cases or a health condition within a population at a designated period.
Risk – the probability of an adverse event within a defined population over a specified interval.
Sample – a subgroup selected from the population under study.