Chapter 37: Epidemiology and Public Health Microbiology, Ch. 37 Epidemiology and Public Health Microbiology

College dormitories are notorious for outbreaks of flu and other infectious diseases. These are particular prevalent during final exam weeks. Using your knowledge of the immune response and epidemiology, suggest practices that could be adopted to minimize the risks at such a critical time.

Conditions that contribute to disease outbreaks during finals include depressed immunity from lack of sleep, poor nutrition, and psychological stress. Spread of infections are promoted by group studying and students being together during the exams themselves.

28. Which of the following contributes to the emergence of new diseases? A. Rapid transportation systems and the mobility of the population B. Ecological disruption such as the loss of predators and the destruction of rain forests C. Increased drug usage and sexual promiscuity D. All of the choices are correct.

D. All of the choices are correct

37. Which of the following is used to reduce or eliminate the source of an infection? A. Treatment of sewage to reduce water contamination B. Destruction of vectors by spraying insecticides C. Destruction of an animal reservoir of the infectious agent D. All of the choices are used to reduce or eliminate the source of an infection.

D. All of the choices are used to reduce or eliminate the source of an infection.

23. Which of the following is a mechanism by which new susceptible individuals enter a population?

D. Birth of new individuals and migration of individuals into the population

7. Which of the following is the major focus of epidemiologists?

D. Both the discovery of factors essential to disease occurrence and the development of methods for disease prevention

49. A group of scientists that are studying the spread of Lyme disease suspect that it is spreading north due to movement of the tick vector brought about by climate change. What application(s) below would assist with this study?

D. Remote sensing and geographic information systems

An infectious disease may: A. be mild B. be severe C. kill the host D. all of the choices

D. all of the choices

The science of epidemiology: A. evaluates the control of disease in a defined population B. evolved in relation to the great epidemic diseases C. embraces all diseases D. all of these

D. all of these

2. The sudden increase in the occurrence of a disease above the expected level is called _________.

D. an epidemic

The sudden increase in the occurrence of a disease above the expected level is called:

D. an epidemic

Which of the following is a mechanism by which new susceptible individuals enter a population?

D. birth of new individuals and migration of individuals into the population

Which of the following is the major focus of epidemiologists?

D. both the discovery of factors essential to disease occurrence and the development of methods for disease prevention

21. An organism that is able to be transmitted from one host to another is said to be _________.

D. communicable

An organism that is able to be transmitted from one host to another is said to be:

D. communicable

44. Precautions that can be taken by individuals to prevent travel-related infectious diseases include

D. wash hands with soap and water frequently and get or update vaccinations appropriate for specific destinations.

Why is a DNA vaccine delivered intramuscularly and not by intravenous or oral routes?

DNA itself is not the antigen. To make the antigen, the DNA must enter host cells ,then be transcribed and translated. Research has shown that muscle cells do this well. Orally given DNA would likely just be degraded in the stomach and intestine. DNA injected into the bloodstream could be taken up by RBCs, but these have no nucleus and would be poor expressers of protein.

12. Public health surveillance is the proactive evaluation of A. genetic background. B. environmental conditions. C. human behaviors and lifestyle choices. D. emerging infectious agents. E. All of the choices are correct.

E. All of the choices are correct.

62. Which of the following public health methods impacted the quality of life through the 20th century by lowering the incidence of many infectious diseases? A. Water treatment B. Strict sanitation guidelines C. Antimicrobial agents D. Immunizations E. All of the choices are correct.

E. All of the choices are correct.

66. Which of the following would play a direct role in coordinating the response of clinical laboratories to a potential bioterrorism incident

E. CDC and APHL

58. Which of the following is recommended for preventing the spread of tuberculosis from a hospitalized patient to others in the hospital environment?

E. Respirators worn by individuals entering the room and placement of a patient in a negative pressure room.

60. Consider the links in the chain of infection. Which of the links is broken when the susceptible members of the population are immunized?

E. Susceptibility

Public health surveillance is the proactive evaluation of: A. genetic background B. environmental conditions C. human behaviors and lifestyle choices D. emerging infectious agents E. all of the choices

E. all of the choices

5. The sudden, unexpected occurrence of a disease in a limited segment of a population is called a(n) _________.

A. outbreak

The ___ rate refers to the total number of individuals infected at any one time regardless of when the disease began.

A. prevalence

Which type of epidemic usually results from the introduction of a single infected individual into a susceptible population?

A. propagated

How can changes in herd immunity contribute to an outbreak of a disease on an island?

Herd immunity should inhibit the spread of an infectious agent. On an island, there may be less of a possibility of re-introduction of the agent, and herd immunity may be enough to eliminate the pathogen from the island

30. The most common types of health-care-associated infections are

B. urinary tract infections.

Diseases of animals that can be transmitted to humans are called:

B. zoonoses

6. The first epidemiologist was _________.

C. John Snow

The first epidemiologist was:

C. John Snow

1. When a disease maintains a relatively steady, low-level frequency at a moderately regular interval, it is called _________.

C. an endemic

When a disease maintains a relatively steady, low-level frequency at a moderately regular interval, it is called:

C. endemic

27. Which of the following is considered a newly emerging disease? A. Escherichia coli O157:H7 B. Cryptosporidiosis C. Hantavirus pulmonary syndrome D. All of the choices are correct.

D. All of the choices are correct.

45. The __________ _____________ ____________ is responsible for the monitoring of infectious disease and the implementation of prevention and control strategies world-wide.

World Health Organization

Why does an inactivated vaccine induce only a humoral response, whereas an attenuated vaccine induces both humoral and cell-mediated responses?

Inactivated vaccines are basically just injections of antigens, as the microorganism is killed. The more immunogenic attenuated vaccine organisms are alive, and interact with the immune system more similarly to the real pathogen

Why is international cooperation a necessity in the field of epidemiology? What specific problems can you envision if there were no such cooperation?

Info about emerging infections must be widely distributed. Coordinated efforts are needed to fight worldwide scourges such as polio. Without these efforts, areas could be blindsided by emerging infections and it would be impossible to eradicate diseases, which commonly cross international borders

What common sources of infectious disease are found in your community? How can the etiologic agents of such infectious diseases spread from their source or reservoirs to members of your community?

Local sources include lakes, water parks, public gather areas. Mechanisms of spread include vectors, wild animals, etc.

10. After an infectious disease has been identified in a population, the next step is to correlate the disease outbreak with a specific organism.

true

40. Vaccines using inactivated pathogens do not stimulate cell-mediated immunity as effectively as vaccines using attenuated pathogens.

true

67. A concerned citizen who suspects that a bioterrorism incident has occurred or will occur should contact 911.

true

29. __________ are the leading cause of health-care-associated diseases.

A. Bacteria

56. Which of the following frequently causes health-care-associated infections of the GI tract?

A. Clostridium difficile

50. A graduate student is researching the spread of mosquito vectors and dengue fever into the southern United States. She has collected a substantial amount of data regarding the locations where the vector has been detected as well as the incidence of the dengue fever virus in both the vector population and in humans. What application would enable her to effectively illustrate patterns of vector and disease spread?

A. Geographic Information Systems

19. Which type of epidemic usually results from the introduction of a single infected individual into a susceptible population?

A. Propagated

53. Consider the following hypothetical situation. Researchers doing influenza surveillance involving molecular analysis of recent isolates of the virus notice a major change in the H and N antigens. What is a likely outcome?

A. The number of cases of influenza will increase significantly.

35. An infected individual who is a potential source of infection for others and plays an important role in the epidemiology of the disease is a/an _________.

A. carrier

The sudden, unexpected occurrence of a disease in a limited segment of a population is called a(n):

A. outbreak

14. The __________ rate refers to the total number of individuals infected at any one time regardless of when the disease began.

A. prevalence

17. A __________ epidemic is characterized by a relatively slow and prolonged rise then a gradual decline in the number of individuals infected.

A. propagated

A ___ epidemic is characterized by a relatively slow and prolonged rise then a gradual decline in the number of individuals infected.

A. propagated

22. The site or natural environmental location in which the causative organism is normally found is called the

A. reservoir

The site or natural environmental location in which the causative organism is normally found is called the:

A. reservoir

how can you prove that an epidemic of a given infectious disease was occurring?

An epidemic is an ocurrence of cases that are above the normal, endemic level for that area. Reports from individual physicians, clinics, and hospitals generally are the first and primary source of infection data.

46. Which agency is specifically responsible of the monitoring of disease and the implementation of prevention and control strategies in the United States?

B. Centers for Disease Control and Prevention

18. Which type of epidemic usually results from a single contaminated source such as food?

B. Common-source

61. Consider the links in the chain of infection. Which of the links is broken when hands are thoroughly washed?

B. Exposure

31. The Centers for Disease Control estimate that __________ of all hospital patients acquire some type of health-care-associated infection.

B. about 5 percent

57. The single most effective and practical way to prevent the spread of infection among patients is

B. attentiveness of health care providers and patients to hand washing.

43. The intentional or threatened use of viruses, bacteria, fungi, or toxins from living organisms to produce death or disease in humans, animals, and plants is known as

B. bioterrorism.

A ___ epidemic is characterized by a sharp rise to a peak than a rapid, but not as pronounced, decline in the number of individuals infected.

B. common source

16. A __________ epidemic is characterized by a sharp rise to a peak then a rapid, but not as pronounced, decline in the number of individuals infected.

B. common-source

Which type of epidemic usually results from a single contaminated source such as food?

B. common-source

36. Chlorination of water supplies represents an epidemiological technique directed at

B. eliminating sources of infection.

3. The first case in an epidemic is called the _________.

B. index case

The first case in an epidemic is called the:

B. index case

65. A disease will be ____________ likely to circulate in a community with a high percentage of individuals who are immune to the disease.

B. less

13. A __________ rate measures the number of individuals who become ill as a result of a specific disease within a susceptible population during a specific time period.

B. morbidity

A ___ rate measures the number of individuals who become ill as a result of a specific disease within a susceptible population during a specific time period.

B. morbidity

4. A(n) __________ is an increase in disease occurrence within a large population over a very wide region (usually the world).

B. pandemic

A(n) ___ is an increase in disease occurrence within a large population over a very wide region (usually the world).

B. pandemic

64. Consider a community in which the vaccination rate for measles is 99 percent. Ryan, a 2-year-old with leukemia, has not received the measles vaccination because of his immunocompromised status. Ryan is unlikely to get measles because

B. there is substantial herd immunity in his community.

59. Eight 10-year-olds in the community became sick within a 24-hour period with vomiting and diarrhea. Personnel from the health department interviewed the children and their families, attempting to determine the source of the illness. Which piece of information below is most suggestive of the common source?

C. All eight children attended the same birthday party two days prior to becoming ill.

20. ___________ immunity is an epidemiological concept that explains the resistance of a population to infection and the spread of an infectious organism due to the immunity of a high percentage of the population.

C. Herd

55. Which of the following is a major cause of health-care-associated infections in the United States?

C. Staphylcoccus aureus

54. Increasing global population, overcrowding and international travel have contributed to many changes in epidemiological trends of infectious disease. Which of the following would have been just as likely to occur a century ago as today?

C. The incidence of bubonic plague in humans, transmitted via the rat flea, is gradually increasing in the United States with most of the cases reported in the west.

51. Which of the following is an example of a noncommunicable infectious disease?

C. Urinary bladder infection

an epidemic is:

C. a sudden increase in the occurrence of a disease above the expected level

8. An epidemic is

C. a sudden increase in the occurrence of a disease above the expected level.

47. The impact of public health measures in the United States has resulted in a/an _______________ in infectious disease-related deaths over the past 100 years.

C. decrease

___ immunity is an epidemiological concept that explains the resistance of a population to infection and the spread of an infectious organism due to the immunity of a high percentage of the population.

C. herd

15. The __________ rate is the relationship of the number of deaths from a given disease to the total number of cases of the disease.

C. mortality

The ___ rate is the relationship of the number of deaths from a given disease to the total number of cases of the disease.

C. mortality

42. It is likely that an act of _________ will be defined by a sudden spike in an unusual disease reported to the public health system.

bioterrorism

48. Over the past 100 years, the number of deaths due to infectious disease has _______________ while the deaths due to metabolic diseases have _____________.

decreased; increased or Increased; remained the same or increased; decreased or remained the same; increased or decreased; remained the same

11. Surveillance of health issues is typically accomplished by two methods: population surveys and antibiotic treatment.

false

24. A major, genetically determined change in the antigenic character of a pathogen is called antigenic drift.

false

34. Most organisms that cause health-care-associated infections come from endogenous sources.

false

52. Ebola Fever would be classified as a communicable non-infectious disease.

false

T/F: Surveillance of health issues is typically accomplished by two methods: population surveys and antibiotic treatment

false

26. The location where a disease-causing organism is normally found is called the __________.

reservoir

25. The immediate location from which a disease-causing organism is transmitted to a host either directly or through an intermediate is called the __________.

source

32. An infection that is incubating in a patient at the time of admission and which develops clinical symptoms during the patient's stay in a health care facility is not considered to be a health-care-associated infection.

true

33. Health-care-associated infections may develop within any health care facility.

true

38. Active immunization of a population will raise the general level of herd immunity.

true

39. Antigens in vaccines are mixed with an adjuvant to enhance the rate and degree of immunization.

true

41. The Public Health Security and Bioterrorism Preparedness and Response Act identifies select agents and identifies a Tier 1 subset of particularly hazardous microorganisms.

true

63. Over the past 100 years, the decrease in deaths due to infectious disease has been somewhat offset by an increase in death due to metabolic diseases.

true

T/F: After an infectious disease has been identified in a population, the next step is to correlate the disease outbreak with a specific organism.

true

9. Living transmitters of an infectious organism from one host to another are called __________.

vectors

Living transmitters of an infectious organisms from one host to another are called ___.

vectors