Final exam Epidemiology of Infectious Diseases 2013

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Name:
Dont forget to put your name above!
THERE ARE 16 QUESTIONS (plus one bonus) IN TOTAL
This is a take home exam. You may use the textbook, your notes from class, and other materials
available on Blackboard or online to find the answers to the questions. You may not consult with others
(in the class or othewise) about your answers.
The exam is to be completed electronically and submitted by June 13, 2013 at 11:59 pm through the
Assignment submission link for the final exam in Blackboard .DO NOT EMAIL EXAMS TO THE
INSTRUCTOR . The exam is designed so that the text for questions is protected. The area for answers
(in blue) is flexible in size, but most questions require only brief answers. Some questions are multiple
choice. For these you can just enter the letter of the answer(s) you chose.
Below is a list of diseases that have been covered in lectures and in student presentations in class.
These are the only diseases about which youll need to know specific things to answer the questions.
Anthrax Kuru
Bacterial meningitis Lyme disease
Bovine spongiform encephalopathy Pertussis
Clostridium difficile Plague
Chagas disease Poliomyelitis
Chickenpox Rubella
Cytomegalovirus Salmonellosis
Ebola Shingles
Gonorrhea Syphilis
Hepatitis A Toxoplasmosis
Hepatitis B Trachoma
Hepatitis C Tuberculosis
HIV/AIDS variant CJD (vCJD)
Invasive Group A Streptococcus

Check your answers for accuracy and completeness before submitting. There will be a substantial
penalty for late submissions.

Final exam Epidemiology of Infectious Diseases 2013
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1. Name five diseases from the list where the known or putative causal agent is not a virus or
bacterium, and name the causal agent for each:

Answer here:
Disease Agent
1.
2
3
4
5





2. Which of the following is usually the primary motivation for epidemiologists conducting an
outbreak investigation: (Choose one.)
a. to control the spread the disease
b. to treat those infected with the disease
c. to educate the public about disease risk
d. to develop a cure for the disease



Answer :






Final exam Epidemiology of Infectious Diseases 2013
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3. A disease outbreak is loosely defined as a sudden increase in disease incidence, above what
is expected in a specific population. There are some diseases where the ocurrence of even a single
case is considered an outbreak requiring immediate investigation. From the following list, choose
one that you think should require immediate investigation if only a single human case were seen in
Philadelphia and briefly explain why. (There is more than one possible correct answer. Your
explanation of the reasons is key.)
Possible diseases:
Cutaneous anthrax Cytomegalovirus
Lyme disease Salmonellosis
Chickenpox in a pregnant woman Gonorrhea
Clostridium difficile Syphilis
Plague Toxoplasmosis
Poliomyelitis Hepatitis C
Rubella in a pregnant woman HIV/AIDS
Skin infection with invasive Group A
Streptococcus


Write name of disease and explanation here:



4. As of April 2013, what countries were considered by the WHO Global Polio Eradication
Initiative to have endemic wild type 1 poliovirus?

Answer here:




5. There are two major behavioral risk factors for prevalent HIV/AIDS in US women. Which one
was the most common before 1994? After 1994?

Answers here:
Before 1994:

After 1994:
Final exam Epidemiology of Infectious Diseases 2013
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6. Why did AIDS activists push for adoption of prognostic markers to predict outcomes in clinical
trials of anti-retroviral medicines? (State briefly in 2-3 sentences.)

Answer here:



7. Which type of vaccine (live attenuated or inactivated) most has the characteristic listed in the
lefthand column of the table below? (Mark X in the column for the vaccine time that is superior.)

Enter answers in table:
Live
attenuated
Inactivated
Immune response includes cell-mediated
immunity

Less sensitive to storage conditions
Requires more doses to attain immunity
Requires replication in vaccinee to be effective
May be unsafe to use in immunocompromised
persons




8. Name two viral infections from the list that can cause serious illness and birth defects in infants
born to infected mothers:

Answer here:



Final exam Epidemiology of Infectious Diseases 2013
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9. As part of the National HIV/AIDS Strategy and Healthy People 2020, the CDC is working to
increase the proportion of people living with HIV/AIDS who know their HIV serostatus. That proportion
is currently estimated to be about 82%.
What two surveillance statistics does the CDC use to estimate this proportion? (The answers are
descriptions of the statistics, not the numbers themselves.)

Answers here:
Numerator:


Denominator:



10. Efficacy of a vaccine can be estimated from: (choose all that apply)
a. Case control studies
b. Randomized clinical trials
c. Cohort studies
d. Population disease surveillance data
e. School vaccine refusal data
f. None of the above

Answer here: (choose all that apply)



11. Name three distinct attributes of infectious diseases that are good candidates for eradication
programs:

Answesr here:
1
2
3



Final exam Epidemiology of Infectious Diseases 2013
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12. Name one zoonotic vectorborne disease from the list that exhibits marked seasonal and
geographic variation in occurrence. Explain briefly.

Answer:



13. Name two diseases from the list in which insects or arthropods are often mechanical vectors for
human infection: Identify the insect/arthropod and how it acts as a mechanical vector.

Answer:



14. Explain briefly why immunization of young children against chickenpox may increase morbidity
and mortality in adults living in their communities:

Answer here:




15. Name two other (i.e. not chickenpox) vaccine-preventable childhood infections where shifting
the age of infection to older ages may increase morbidity and mortality. Briefly explain how this might
occur for each disease.

Disease 1:


Disease 2:




Final exam Epidemiology of Infectious Diseases 2013
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16. According to the CDC, organisms that pose the highest risk as bioterror agents (Class A) are
ones which can be can be easily disseminated or transmitted from person to person; result in high
mortality rates and have the potential for major public health impact; might cause public panic and
social disruption; and require special action for public health preparedness. Class B agents are defined
as those that are moderately easy to disseminate, cause moderate morbidity and low mortality rates,
and require enhanced surveillance.
Of those on the list for this exam, anthrax, plague, and Ebola are considered Class A agents, and
Salmonellosis is considered a Class B agent.
Clostridium difficile is not on the list of Class A or Class B agents. Briefly explain why, despite its
seriousness, it has not been included. Then give two distinct reasons why it should be added to the list
of Class A or B agents.

Explanation of why C diff is not on the list of Class A or B agents:




Two reasons to consider adding C diff to the list of potential bioterror agents:


Bonus question: Name two zoonotic infections from the list where house cats are
mentioned specifically as susceptible to the disease and/or important in
transmission to humans. Explain why cats should or should not be blamed for this.


Answer here:




END OF EXAM

Make sure your name is on the first page.
Make sure you have answered all 16 questions.
Save this document and submit via the Assignments link in Blackboard.
Have a great summer!
Congratulations to graduates!!!