Quiz 9

11. During the 20th century, the emergence of several new influenza A virus subtypes have caused pandemics; all of which spread around the world within a year of being detected. One of these is suspected of killing over 675,000 in the US and over 50 million globally. That deadly pandemic was called the (A) 1918-19, "Spanish flu," [A (H1N1)] (B) 1957-58, "Asian flu," [A (H2N2)] (C) 1968-69, " Hong Kong flu," [A (H3N2)] (D) 2003-2004 Severe Acute Respiratory Disorder [SARS] (E) 1972-present West Nile Virus [WNV]

(A) 1918-19, "Spanish flu," [A (H1N1)]

22. In a bioweapons attack, there are the unique challenges with first response because (A) The release of biological agents is not likely to be immediately discernible (B) Casualties will immediately in the first 24 hours, overwhelm medical attention (C) Firefighters, police and paramedics would most likely desert immediately. (D) Physicians specifically ID specialists, are likely to be out of town (E) There are no know treatments for any of the sentinel six bioweapons agents

(A) The release of biological agents is not likely to be immediately discernible

18. The United States (A) has conducted significant research on the use of bioweapons (B) has never experienced a bioweapons attack yet on its own soil (C) has effectively prevented bioweapons attacks in the US (D) secretly attacked the former Soviet Union because of their research on bioweapons in 2005 (E) has no known research on bioweapons

(A) has conducted significant research on the use of bioweapons

23. A notorious attack that used bioweapons in Oregon in 1984 was perpetrated by a cult in an attempt to sway an upcoming election. Cult members were found to have contaminated commercial salad bars with what organism? (A) Ebola virus (B) Salmonella (C) Yersinia pestis (D) Small pox (E) Anthrax

B) Salmonella

2. An influenza pandemic is a global outbreak of disease that occurs when a new influenza A virus appears or "emerges" in the human population, causes serious illness, and then spreads

B) easily from person to person

4. Pandemics: (A) are different from seasonal outbreaks or "epidemics" of influenza. (B) are outbreaks that are caused by new influenza subtypes (C) are outbreaks that are caused by influenza subtypes that have never circulated among people or by subtypes that have not circulated among people for a long time (D) in the past have led to high levels of illness, death, social disruption, and economic loss on a global scale (E) All of these answers is correct

E) All of these answers are correct

15. The emergence of several new influenza A virus subtypes have caused pandemics during the 20th century; one important clue about their origins is that (A) the viruses contain a combination of human genes and/or animal host species (B) the all occurred in large urban areas in Western Europe (C) they are not transmissible from human to human (D) they were all genetically engineered (E) they appeared with the onset of antibiotic use in Southeast Asia

(A) the viruses contain a combination of human genes and/or animal host species

20. During the historical development of bioweapons it is known that: (A) in 142-73: US program of offensive and defensive BW, including human "volunteer" exposures with Ebola virus (B) 1942-73: US program of offensive and defensive BW, including human "volunteer" exposures (C) 1992-73: US program of offensive and defensive BW, including human "prisoner" exposures to Yersinia pestis and syphllis (D) 1998-03: US program of offensive and defensive BW, including human "military" exposures genetically (E) Anthrax was developed and weaponized by a cult in Oregon to secure land during a controversial election

(B) 1942-73: US program of offensive and defensive BW, including human "volunteer" exposures

10. Who is monitoring global emergence of influenza viruses? (A) The US Department of Agriculture (USDA) and the Food and Drug Administration (FDA) in the United States (B) The U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) (C) The Environmental Protection Agency (EPA) in the United States (D) The Republican Party (GOP) related to the Personal Health Care Act issues (E) The Academy Awards Committee (AAC) for accuracy of the film Contagion

(B) The U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO)

16. The Dual Use Dilemma refers to: (A) The complicated situation of a train platform and whether to sacrifice one life to save five (B) The basic research on viral genetics and transmissibility that could be used to combat pandemics and the use of that knowledge for the creation of bioweapons. (C) The use of one antibiotic to treat two separate pandemic subtypes (D) The use of basic scientific research for profit (E) The use of theoretical dilemmas when real lives are at high risk through pandemics

(B) The basic research on viral genetics and transmissibility that could be used to combat pandemics and the use of that knowledge for the creation of bioweapons.

13. Vaccines can be made to protect against pandemic influenza viruses, but (A) it would be too costly to be effective and therefore not manufactured by major pharmaceutical companies (B) a vaccine probably would not be available in the early stages of a pandemic (C) requires 12 years and would cost over $1.5 billion from bench to bedside (D) can only be produced using the attenuated vaccine approach in chicken eggs (E) could never be over 50% effective so would not interrupt a full blown pandemic

(B) a vaccine probably would not be available in the early stages of a pandemic

6. There are many different subtypes of Influenza or "flu" viruses. The subtypes differ based upon certain proteins on the surface of the virus are used to classify the subtypes are designated (A) only for avian flu subtypes (B) as HN based on the hemagglutinin or "HA" protein and the neuraminidase or the "NA" protein. (C) specifically by the WHO for seasonal flu vaccine production (D) by their animal host reservoir whether they are avian (AV), pigs (PG), or bats (BT) (E) when they reach Phase 3 pandemic level as HuHu3

(B) as HN based on the hemagglutinin or "HA" protein and the neuraminidase or the "NA" protein.

14. Antiviral medications have been made and tested to prevent and treat influenza (A) of the seasonal subtypes only, and will be of little use in a pandemic (B) including four different influenza antiviral medications (amantadine, rimantadine, oseltamivir, and zanamivir) (C) but are not yet approved by the U.S. Food and Drug Administration (FDA) for the treatment and/or prevention of influenza (D) but will only be available for underdeveloped countries provided by the UN and the WHO to prevent the pandemic spread to developed countries (E) but cannot be commercialized because of perceived controversies about the manufacture and possible side-effects

(B) including four different influenza antiviral medications (amantadine, rimantadine, oseltamivir, and zanamivir)

21. The reasons that small pox is considered such a dangerous threat as a bioweapon include: its stability in aerosol form; infective dose low ~10-100 organisms; and, efficient person-to-person spread. The fact that a transmissible person can infect many other persons has created what possible threat since 9/11 that was not previously seriously considered? (A) that a reliable vaccine against small pox cannot be constructed (B) that suicide terrorists could inject themselves with a virulent strain to spread it through an unsuspecting population (C) that the ultimate suicide mission would be to unleash a bioweapon that would kill everyone on the planet (D) that a strain of small pox could be fused with portions of the bird flu virus to be deployed as a bioweapon (E) it is not important enough

(B) that suicide terrorists could inject themselves with a virulent strain to spread it through an unsuspecting population

17. Bruce Ivans (A) won the Nobel prize in medicine for research on bioweapons (B) was the highly suspected perpetrator of 2001 Anthrax attack in the US (C) conducted research on Iraqi bioweapons with Saddam Hussein's regime at the Al-Shazam Institute that led to the Iraq war (D) was a senator for Rhode Island during the first Gulf War leading policies against bioweapons research (E) won the Nobel Peace prize for his stance against bioweapons

(B) was the highly suspected perpetrator of 2001 Anthrax attack in the US

17. Many scientists believe it is only a matter of time until the next lethal influenza pandemic occurs. The severity of the next pandemic cannot be predicted, but modeling studies suggest that the impact of a pandemic on the United States could be substantial. In the absence of any control measures (vaccination or drugs), it has been estimated that in the United States a "medium-level" pandemic could cause (A) 9,000 to 7,000 deaths, 4,000 and 5,000 hospitalizations (B) 589,000 to 1207,000 deaths, 3,814,000 and 9,734,000 hospitalizations (C) 89,000 to 207,000 deaths, 314,000 and 734,000 hospitalizations (D) over 10,000 hours of missed work time (E) a cancelation of the Academy award ceremonies

(C) 89,000 to 207,000 deaths, 314,000 and 734,000 hospitalizations

3. An influenza pandemic is a global outbreak of disease that occurs when a new influenza A virus appears or "emerges" in the human population, causes serious illness, and then spreads easily from person to person worldwide. An influenza pandemic (A) is a theoretical concern of the WHO and the CDC (B) has not occurred in the US since the famous 1918-19 Spanish Flu (C) has occurred several time in the last 100 years with devastating consequences (D) will not unlikely occur in the next fifty years but is a significant concern to the USDA (E) None of these answers is correct

(C) has occurred several time in the last 100 years with devastating consequences

19. Synthetic biology (A) will most likely never be used on bioweapons (B) can never be applied to bioweapons research (C) is a problem considered in the Dual Use Dilemma (D) is not a large threat to the deployment of future bioweapons (E) was used to develop weaponized bioweapons to produce the Anthrax used in the 2001 US attack by Saddam Hussein's regime

(C) is a problem considered in the Dual Use Dilemma

1. The film Contagion (A) entirely depicts a situation that could never possibly happen in the US based on and H8N14 outbreak (B) is entirely science fiction and depicts only a Hollywood version of pandemic (C) is a theoretical depiction based on what might happen in a global pandemic (D) is based on the alien invasion of a virus that takes over the planet that could actually happen (HxNv) (E) is a documentary based on the 1957-58 pandemic of the Hong Kong flue (H3N5)

(C) is a theoretical depiction based on what might happen in a global pandemic

9. Changes in the viral genome result in a new influenza A virus subtype. The appearance of a new influenza A virus subtype is the first step toward a pandemic; however, to cause a pandemic, the new virus subtype also must (A) escape detection by viral researchers and the CDC (B) be transmissible through agricultural crops, such as is now feared through genetically modified corn (C) be able to use bats as it animal host (D) have the capacity to spread easily from person to person (E) be based on the genomic sequence that is the same as the 1918 Spanish flu virus

(D) have the capacity to spread easily from person to person

5. How will the next global pandemic most likely move most effectively? (A) Cargo ships from southeast Asia which inadvertently may carry infected fruit bats (B) Infected military personnel returning from service in the Middle East (C) Contaminated food sources from Mexico (D) human to human transmission facilitated by air travel (E) As a computer virus transmitted through social media

(D) human to human transmission facilitated by air travel

12. The Stages of a Pandemic, characterized by the World Health Organization recognizes a Phase 6 Pandemic when: (A) an emergent influenza virus is recognized in an animal host species (B) human infection(s) with a new subtype have occurred, but there is no human-to-human spread (C) Small cluster(s) with limited human-to-human transmission but spread is highly localized (D) increased human to human transmission occurs and sustained transmission in general population (E) the virus has become sexually transmissible

(D) increased human to human transmission occurs and sustained transmission in general population

8. Pandemic viruses emerge as a result of a process called "antigenic shift," which causes an abrupt or sudden, major change in influenza A viruses. These changes are caused by (A) people who do not practice good personal hygiene (B) molecular biologists that study viral transmission (C) an overuse of antibiotics (D) new combinations of the HA and/or NA proteins on the surface of the virus during viral evolution (E) alternative medical therapies in Southeast Asia

(D) new combinations of the HA and/or NA proteins on the surface of the virus during viral evolution

18. There is a so-called Sentinel Six Infectious Agents that are considered Category A bioweapons which do not include: (A) H1N5 avian flu virus (B) Anthrax and Small Pox (C) Plague and Tularemia (D) Botulism (E) Ebola: Hemorrhagic Fever

A) H1N5 avian flu virus

7. PCR is useful for use in plant genetics, pharmacogenomics, evolutionary studies, pandemic flu, and analysis of bioweapons (A) False (B) True (C) only when a plant geneticist thinks his collaborator stole his work (D) only when forensic analysis involves bioweapons from a anthrax attack (E) This is true for everything except its use on pandemic flu.

A) True