ICEBERG PHENOMENON

Icebarg of disease
  • Disease in a community may be compared with an iceberg.
  • The floating tip of the iceberg represents what the physian sees in the community, i.e. clinical cases (Diagnosed case, symptomatic case or clinically apparent case). It includes sub-clinical cases & carriers
  • The vast submerged portion of the iceberg represents the hidden mass of disease, i.e. latent, inapparent, presymptomatic and undiagnosed cases and carriers in the community. The "waterline" represents the demarcation between apparent and inapparent disease.
  • Epidemiologist is concerned with Hidden portion of iceberg whereas clinician is concerned with tip of iceberg.
  • Screening is done for Hidden portion of iceberg whereas diagnosis is done for tip of iceberg.
Iceberg phenomenon of disease is not shown by rabies, tetanus and measles.
  • The clinician concerned only with the tip of iceberg, i.e symptomatic cases that are seen in clinical treatment, this can result in inaccurate view of the nature and causes of a disease results because the minority of the cases are studied (hidden cases :-. submerged portion of ice berg is not studied) → Clinician's Fallacy. In some disease, a great deal of subclinical infection occurs -
  • Rubella 
  • Polio 
  • Japanese encephalitis 
  • Influenza
  • Mumps 
  • Hepatitis A and B 
  • Diphtheria
Exam Question
  • Infectious disease showing iceberg phenomenon are Rubella, Influenza, Polio, Japanese encephalitis, Mumps , Hepatitis A and B & Diphtheria
  • An infectious disease shows iceberg phenomenon. That means it has More subclinical case
  • Demarcation line in iceberg disease is between Apparent and inapparent cases
  • According to the concept of iceberge phenomenon of disease It includes sub-clinical cases, carriers & It constitutes undiagnosed reservoir of infection Iceberg phenomenon differentiates Apparent and inapparent
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