Index patient

Patient Zero is a redirect to this article. For the film by Stefan Ruzowitzky see Patient Zero (film) .

As index patient (literally Note patient of Latin index , display ' , Notice') even index case is referred to in the epidemiology that person, from the spread of a disease took its secured or presumed output as in infectious or hereditary diseases of the case that spread infectiously or genetically .

This first sick person is also called patient zero (in the English-speaking world, patient zero ).

Examples

• In the blood essential that would be blood donors of the index patient , from which - by its contaminated - blood pathogens (pathogens) to one or more recipients its recovered blood products have been transferred (→  infection ) . The infected recipient (s) and the index patient to be identified are the most important starting points for the implementation of a so-called look-back procedure in which all donors of a specific recipient and all recipients of donations from the index patient must be identified.
• If a nosocomial infection ("hospital infection "), an accident at work or the like with potentially infectious blood (e.g. a needle stick injury ) is suspected , the patient from whom the blood and / or the needle came is referred to as the index patient .

Reconstruction of the infection routes

When reconstructing the spread , the chains of infection are examined in order to make statements about transmission routes (animal → human, human → human, air or droplet infection), the likelihood of infection (“How many people are infected?”), The likelihood of illness (“How many infected people get sick after all? ”), latency (“ How long does it take for symptoms of the disease to appear? ”) and mortality (“ How many sick people die from it? ”). All sick people are interested.

HIV / AIDS outbreak from 1959

The oldest blood samples from people infected with the human immunodeficiency virus (HIV) date from 1959. It is likely that these people also developed AIDS . However, since the disease was not known at the time, this can only be assumed in retrospect, but not proven.

For some time, the French- Canadian Gaëtan Dugas was considered an index patient for the spread of HIV and AIDS in the United States . However, the first known person with AIDS on the North American continent was the African American Robert Rayford from Missouri, who died in May 1969 at the age of 15 of Kaposi's sarcoma . In 1987, researchers at Tulane University School of Medicine demonstrated an HIV-1 virus infection in this patient in stored blood samples.

Ebola outbreak in West Africa from 2013

The first person to contract Ebola in West Africa in 2013 was a two-year-old child of a young mother from Meliandou, a village in the Guéckédou prefecture in Guinea . The child developed a fever, stomach cramps, and vomiting on December 2, 2013, and died on December 6, 2013. Within three weeks, his three-year-old sister, mother, grandmother and a nurse who cared for them all died. As the village of Meliandou lies on the border between Guinea, Sierra Leone and Liberia, the disease spread rapidly through contact infection (contact with sweat and blood, among other things) in all three countries.

The index patient in psychotherapy

In systemic therapy , a group member with its symptoms constricting Reality constructions and unfortunately convincing interaction patterns within the group indicating also the index patient referred. The person who first declares himself “sick” in a problematic network of relationships is the index patient.

See also

• Infectivity
• Contagiousness

Individual evidence

1. ↑ Wolfgang Kiehl: Infection protection and infection epidemiology. Technical terms - definitions - interpretations. Ed .: Robert Koch Institute, Berlin 2015, ISBN 978-3-89606-258-1 , p. 66, keyword index case .
2. ^ Patient Zero. In: TheFreeDictionary - Medical dictionary. Retrieved March 14, 2014 . 
3. ↑ T. Zhu, BT Korber, AJ Nahmias, E. Hooper, PM Sharp, DD Ho: An African HIV-1 Sequence from 1959 and Implications for the Origin of the Epidemic . In: Nature . 391, No. 6667, 1998, pp. 594-597. bibcode : 1998Natur.391..594Z . doi : 10.1038 / 35400 . PMID 9468138 .
4. ^ RF Garry, MH Witte, AA Gottlieb, M. Elvin-Lewis, MS Gottlieb, CL Witte, SS Alexander, WR Cole, WL Drake: Documentation of an AIDS virus infection in the United States in 1968 . In: JAMA . 260, No. 14, October 1988, pp. 2085-2087. doi : 10.1001 / jama.260.14.2085 . PMID 3418874 .
5. ↑ Frank Patalong: Patient Zero: Researchers reconstruct the way in which the Ebola epidemic spread. In: Spiegel Online. August 10, 2014, accessed August 10, 2014 . 
6. ^ A. Vossler: As an index patient on the therapeutic side? Children in systemic family therapy and counseling. In: Practice of child psychology and child psychiatry. July-August 2000, 49 (6), pp. 435-449, PMID 11008483 .
7. ↑ http://www.spektrum.de/quiz/wen-bezeichen-systemische-therapeuten-als-indexpatienten/1022231