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Subject: Terminology: Epidemic vs. Outbreak rss

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Donovan K. Loucks
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Does anyone else feel like the use of the terms "epidemic" and "outbreak" is reversed in Pandemic? To me, an epidemic is the further spread of existing disease and an outbreak is an entirely new eruption of that disease. Yet in Pandemic, the opposite is true. I thought that perhaps my understanding of these terms was simply reversed, but I looked it up:

epidemic: a rapid spread
outbreak: a sudden eruption

I love the game but I always have to do a double-take when either occurs.
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brian
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The terms seem right to me. An outbreak in the game is an eruption that spills over to the other cities. You're "breaking out" of the confined area of an existing disease.

Epidemic always seemed like something that was specific to one locale. The origin of the word on Dictionary.com states:
Quote:
Origin: 1595–1605; obs. epidem(y) (< LL epidémia < Gk epidémía staying in one place, among the people, equiv. to epi- epi- + dêm(os) people of a district + -ia -y3) + -ic

And that seems correct in that it is a localized disease.

But the terms are synonyms and probably could have been used the other way just as easily.
 
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Kevin Peters Unrau
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DonovanLoucks wrote:
Does anyone else feel like the use of the terms "epidemic" and "outbreak" is reversed in Pandemic?


My understanding is that epidemic refers to an infection in a specific area. Allowing the disease to spread causing "outbreaks" in new locations can lead to a Pandemic. It all seems correct to me.
 
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Franco
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In population health, the word epidemic has taken on more meaning than just infectious disease, now including chronic diseases as well. But even in its original usage it was used for both the local and wider spread of disease. An outbreak, as well, could imply local infectious disease or something wider.

But I side with the OP on the connotation of the words. For me an outbreak is something "emerging" within a population (I've never thought of it as meaning, say, the jumping of disease from city to city), while an epidemic is already widespread or well above expected rates.
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Donovan K. Loucks
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I found the following definitions online by simply searching for the keywords "epidemic", "outbreak", and "definition". They mirror my understanding of the terms.
Quote:
Confusion sometimes arises because of overlap between the terms epidemic, outbreak, and cluster. Although they are closely related, epidemic may be used to suggest problems that are geographically widespread, while outbreak and cluster are reserved for problems that involve smaller numbers of people or are more sharply defined in terms of the area of occurrence. For example, an epidemic of influenza could involve an entire state or region, whereas an outbreak of gastroenteritis might be restricted to a nursing home, school, or day-care center. The term cluster may be used to refer to noncommunicable disease states.
Despite this clarification, it does seem that the terms are so related in meaning that this probably isn't something that bothers other people. I guess I'll just keep doing my double-takes...
 
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Donovan K. Loucks
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I had to add these definitions, which are from a textbook called Medical Epidemiology by Raymond S. Greenberg, Stephen R. Daniels, W. Dana Flanders, John William Eley, and John R. Boring:
Quote:
A rapid and dramatic increase in the occurrence of a disease is referred to as an epidemic.

Quote:
A disease outbreak is an epidemic that occurs suddenly and within a relatively confined geographic area.
Given how epidemics and outbreaks are executed in Pandemic, this definitely sounds backwards to me. However, documents by the CDC indicates that these terms can be used interchangeably. Oh, well.
 
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Tony Chen
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I agree with the OP here.
 
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Branko K.
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I'm a non-native speaker, and I must say "Outbreak" sounds more natural to me for what it represents - a disease "outbreaking" from the confines of the city to the neighboring cities.

"Epidemic" to me sounds a bit more vague and general.
 
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Gene Warren
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I did my undergrad work in public health, and I will have to echo the idea that the terminology is incorrect with regard the predominant professional usage. However this particular conflation happens in the media all the time, and plenty of people in the field do this too.

Since Pandemic is a strategic level game, I suppose one could alleviate any cognitive dissonance by viewing the 'outbreaks' as the occurrence of multiple rapid (localized) outbreaks in the surrounding area, that are abstracted together based on game scale.
 
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Chris Norwood
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Yeah, the OP is probably right on the most technical level.

But for gameplay, I think its current use of the words is more descriptive than if they were reversed. When a city would get its fourth cube, around here we say that it "breaks", and then disease spills out to the surrounding cities. It just seems right for the game to me.
 
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Joe Braun
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From "A Dictionary of Epidemiology" by John Last.

Epidemic: The occurrence in a community or region of cases of an illness, specific health related behavior, or other health-related events clearly in excess of normal expectancy.

Outbreak: An epidemic limited to localized increase in the incidence of a disease, e.t., in a village, town, or closed institution.

Pandemic: An epidemic occurring worldwide, or over a very wide area, crossing international boundaries, and usually affecting a large number of people.

So for example:

HIV/AIDs is a pandemic.
Outbreaks of gastrointestinal illness from food poisoning are an outbreak.

Heart disease in the United States is an epidemic (although one could argue it is a pandemic across industrialized nations).

Note: I am an epidemiologist.
 
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Franco
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Harry Plopper wrote:
From "A Dictionary of Epidemiology" by John Last.


Wow! I usually find myself in disagreement with the definitions in Last, as many of them are sloppy, but here I would agree.
 
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Antonio Chavez
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loquitur wrote:
Harry Plopper wrote:
From "A Dictionary of Epidemiology" by John Last.


Wow! I usually find myself in disagreement with the definitions in Last, as many of them are sloppy, but here I would agree.


Would you say he had the Last word?
 
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Joe Braun
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That's punny.
 
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Joe Braun
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I TAed an introductory graduate level epidemiology class and you would be surprised by some of the answers I got for test questions. Some people who had been working in public health couldn't answer some basic definitions.
 
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