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Principles of Infectious Disease Epidemiology
Final Test

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1. Fill in the blanks. Epidemiology is the science of the __________ of disease and its __________.

a. symptoms and environment
b. distribution and determinants
c. clinical history and complications
d. organisms and spread

2. The American Public Health Association (APHA) defines key terms used to describe basic patterns of infectious disease occurrence:

a. epidemic
b. endemic
c. parasitic
d. pandemic
e. a, b, d
f. all of the above

3. The main purpose of epidemiology is to:
a. develop research projects and obtain funding for them
b. discover new prevention methods and cures for diseases
c. understand the causes of health problems and guide efforts to improve health
d. find out who is responsible for an outbreak and punish them

4. Fill in the blank.  The transition from endemic to __________ can happen in days, weeks, months, or even years, depending on the disease.

a. sporadic
b. epidemic
c. zoonotic
d. epidermic

5. The term epidemiology is used to refer both to:  A method of study of diseases, and a body of knowledge about the natural history of a disease.

True False

6. John Snow, a British scientist, did pioneering work during a cholera outbreak in London in 1854.  He identified the cause of the outbreak by:

a. determining the water sources of various neighborhoods
b. testing the drinking water
c. calculating cholera death rates in neighborhoods with different water sources
d. doing autopsies on the cholera victims
e. a and c
f. all of the above

7. Disease is a result of the interaction of , , and .
8. Select the statement that is False.

a. Metazoa are multicellular animals, many of which are parasites.
b. Protozoa are single-cell organisms with a well-defined nucleus.
c. Fungi are nonmotile, filamentous organisms.
d. Bacteria are single-celled organisms with a well-defined nucleus.

9. Name the three types of reservoirs of infection: , , and .

10. Fill in the blank.  Carriers are people who harbor infectious agents but are not __________.

a. terminal
b. contagious
c. ill
d. active

11. In the environment the following may serve as the reservoir of infection for a variety of diseases:

a. plants
b. sunlight
c. soil
d. water
e. a, c, d
f. all of the above

12. The portals most commonly associated with human and animal diseases are:

a. respiratory
b. genitourinary
c. alimentary
d. skin
e. transplacental
f. all of the above

13. Anything in the environment can serve as a vehicle for disease agents, including objects, food, water, milk, or biological products.

True False

14. The last essential component in the chain of infection is the susceptible host.  Susceptibility is affected by:

a. genetic factors
b. general resistance factors
c. Th1-type immunity
d. specific acquired immunity
e. a, b, d

15. Part of the variation in the broad range of responses to an infectious agent is due to the capacity of the agent to produce disease and to differing levels of resistance of the hosts.

True False

16. To be effective, public health surveillance systems must involve public health agencies, healthcare providers, and the public.

True False

17. Describing and monitoring health events and trends through surveillance systems can allow us to:

a. Detect sudden changes in disease occurrence and distribution.
b. Follow long-term trends and patterns of disease.
c. Interpret current disease situations.
d. Identify changes in agents and host factors.
e. Use appropriate data to direct vaccine production, treatment, and other prevention and control measures.
f. All of the above

18. When surveillance data showed that a new arbovirus, the West Nile Virus, was spreading across the country, public health agencies developed plans to prevent and control it.  They tried several new approaches including:  public education campaigns to promote the use of mosquito protections; public education and code enforcement activities to reduce mosquito breeding sites; and community cleanup activities to reduce mosquito habitat.  This is a good example of using surveillance data to:

a. Set priorities for the use of resources.
b. Plan, implement and evaluate public health interventions and programs.
c. Evaluate public policy.
d. Generate questions that provide direction for further research.
e. Identify when the public health problem has been solved.

19. Ideas about the causes of disease and potential control measures can be developed into research hypotheses that lead to new knowledge in disease prevention and control.

True False

20. In Missouri, the following individuals are required to report diseases:

a. physicians
b. patients
c. persons in charge of a public or private school
d. nurses
e. a, c, d
f. all of the above

21. There are two forms of surveillance, passive and impassive.

True False

22. Current surveillance data may be compared with some expected value to identify how they differ and to assess their importance.  One way to do this is by comparing the incidence rate in the current time period with past incidence in the same jurisdiction.

True False

23. What are the two main types of morbidity rates commonly used in epidemiology?

a. point prevalence rate and period prevalence rate
b. incidence rate and prevalence rate
c. crude death rate and cause-specific death rate
d. relative risk and odds ratio

Fill in the letter of the definition of each type of rate:

24. Incidence rate
25. Attack rate
26. Secondary attack rate

a. a measure of the frequency of new cases of a disease among the contacts of known cases
b. a measure of the frequency with which new cases of a disease occur in a population over a period of time
c. a comparison of the rates of disease in two groups that differ by demographic characteristics or exposure history
d. a specific type of incidence rate, calculated for a narrowly defined population observed for a limited time, such as during an outbreak

Fill in the letter of the definition of each type of rate:

27. Period prevalence rate
28. Point prevalence rate
29. Cause-specific mortality rate

a. a measure of the frequency of occurrence of death from all causes in a population during a specified time period
b. a measure of the frequency of occurrence of death from a specified cause in a defined population during a specific time period
c. a measure of the proportion of people in a population who have a particular disease at a specified point in time
d. a measure of the proportion of people in a population who have a particular disease over a specified period of time

30. Epidemiologic variables may be characteristics of: , , or .

31. There are three basic methods of organizing epidemiologic data:

a. case studies
b. tables
c. charts
d. graphs
e. a, b, c
f. b, c, d

32. Which of the following is/are valid reason(s) for analyzing epidemiologic variables?

a. identify individuals responsible for disease transmission
b. identify important characteristics of the cases
c. diagnose a patients illness
d. form hypotheses about the source, agent and mode of transmission
e. b and d
f. b and c

33. Variations in the frequency of a disease over time may result from:

a. true increases or decreases – actual changes in the frequency of the disease in that population
b. changes in sensitivity or specificity of the surveillance system
c. mistakes made in collecting or organizing the data
d. changes in the perceptions of the public or the health care community about the importance of diagnosing and reporting that particular disease
e. a and c
f. all of the above

34. When making comparisons between different time periods, places, and groups of people, be sure the data are comparable with respect to:

a. case definitions
b. variety of healthy activities
c. level of effort in case-finding and data collection
d. time periods
e. populations
f. a, c, d, e

35. People can be described in terms of many inherited or acquired characteristics.  Age is the single least important personal characteristic.

True False

36. Fill in the blank. If there is a gender difference in a particular disease it usually means either males or females had a greater opportunity for _________.

a. avoidance
b. exposure
c. warning
d. prevention
e. a and c
f. all of the above

37. Epidemiologic interviews may:

a. Obtain complete data for disease reporting and analysis.
b. Provide “clues” that lead to hypothesis development.
c. Identify the source and/or connections between disease cases or outbreaks.
d. Help prevent the development of disease in those potentially exposed.
e. Help prevent the complications of untreated disease in those already infected.
f. All of the above

38. Discussing common interests; showing the person that this is not just a job, and that you truly care about their health and the health of those around them; and explaining the goal of the interview and how it will benefit the person and others.

a. What is teambuilding?
b. What is rapport?
c. What is friendship?
d. What is consensus?
e. What is quality?

39. Interviewing is a voluntary process, which requires the acceptance and cooperation of the person being interviewed.

True False

40. Fill in the blank. The preservation of confidentiality is established by health department policy and practice, and by state and federal statutes.  The interviewer should __________ the policies and procedures of his or her agency.

a. memorize
b. disregard
c. be familiar with
d. never revise
e. a, d

41. Non-verbal communication is not very important in effective interviewing, and some say the actual words we use have the most importance.

True False

42. Effective listening is a vital part of communication.  Effective listening includes non-verbal and verbal feedback to the person who is talking.

True False

43. A good interviewer may “lead” a person to a particular answer, because of your strong suspicion about what the answer “should be.”

True False

44. Preparing an interim report can help clarify the investigator’s understanding and provide new insights.

True False

45. In an outbreak investigation report, the Introduction should set the scene for the investigation.  It should include:

a. date of initial report
b. agency that received the initial report
c. place and date of the outbreak
d. brief biography of the person submitting the report
e. name and official title of the person submitting the report
f. all of the above
g. a, b, c, e

46. Which section of the outbreak investigation report should answer the reader’s questions about what was done, how and by whom?  (It should include items like:  What and how much data was collected?  How were case definitions(s) developed and used?  and  What hypotheses were developed?)

a. the Analysis section
b. the Results section
c. the Control Measures section
d. the Methods section
e. the Recommendations section

47. In the outbreak investigation report, the Analysis section is the place to present what you have learned from the investigation.  It should show your conclusions and interpretations regarding the source of infection; agent; reservoir; mode of transmission; and the group at highest risk.

True False

48. In the outbreak investigation report, the Control Measures (such as how methods were implemented, when they were implemented, and how their effectiveness was measured) are the same as Recommendations.

True False

49. Fill in the blank. In the outbreak investigation report, Other Outcomes is the section that describes what the outbreak and the efforts to control it have done to the __________ affected.

a. assumptions
b. animals
c. methods
d. procedures
e. population

50. At a minimum, the final report of an outbreak investigation should go to the:

a. American Epidemiological Society
b. investigation team members
c. administrator of the investigating health agency
d. DHSS (Regional Communicable Disease Coordinator and state office)
e. b, c, d
f. all of the above