Final Exam Review

Question 1

Understand why new diseases (particularly zoonotic and vector-borne diseases) are emerging so frequently in recent times

Answer 1

EI-ICE

1. Ecological changes or disruption (particularly climate change)
2. Introduction of animals/ people to new areas
3. Increasing global movement (people and animals)
4. Cultural changes and changes to agricultural practices
5. Enhanced disease surveillance and detection e.g. molecular methods

Question 2

What would you do to control and prevent foodborne disease?

Question 3

What is veterinary public health?

Answer 3

The sum of all contributions to the physical, mental and social well-being of humans through an understanding and application of veterinary science

Question 4

What is “one health?”

Answer 4

Concept incorporating interdisciplinary collaborations and communications in all aspects of healthcare for humans, animals, and the environment. Recognizing that human health, animal health, and ecosystem health are inextricably linked.

One health seeks to promote, improve, and defend the health and well-being of all species by enhancing cooperation and collaboration between physicians, veterinarians, and other scientific health and environmental professionals.

Question 5

Zoonotic diseases vs. Foodborne diseases with veterinary involvement

Answer 5

Zoonotic diseases- Diseases of humans in which the infectious agent is acquired from animals and for which animals are the reservoir of infection.

Food borne diseases can be from zoonoses infected that animal, infectious diseases due to contamination, diseases due to the presence of chemicals or toxins (natural or contamination)

Question 6

Describe the broad range of impacts that these emerging infectious diseases can have on animals, people and the environment

Question 7

Describe the different roles that veterinarians can play in investigating, controlling and preventing emerging infectious diseases

Question 8

What is an emerging disease?

Answer 8

One one that has appeared in a population for the first time or that may have existed previously but is rapidly increasing in incidence or geographic range. (About 1 new disease per year for the past decade or more)

Question 9

Explain and provide an example of the ecological changes or disruption aspect of EIDs? Examples?

Answer 9

Climate change–> precip, extreme weather (droughts and floods), and seasonal shifts which impact disease agents, vectors, and hosts and their interactions.

* Disease agents- altered pathogen survival, Vectors- change to habitat, hosts- stress, malnutrition

* Examples: Hendra virus- floods and extreme weather in QLD caused flying foxes to move further south to northern NSW where the first cases of Hendra Virus emerged due to naive population of flying foxes therefore when infected, increased viral shedding, increased chance of spillover

Question 10

Why does the introduction of animals/ people to new areas result in increased EIDs?

Answer 10

* Displacement for political, social, or economic factors brings domestic animals and people into contact with wildlife and their infectious agents to which they had not previously been exposed– can occur periodically, Hendra Virus or sustained transmission and the disease becomes established in that host population e.g. HIV

Question 11

Why is increasing global movement of people and animals a factor in EIDs?

Answer 11

* Movement of people and animals is not new but the scale and speed of this movement has increased dramatically in recent history

* visitors or new populations may have no immunity to introduced pathogens e.g. malaria

* genetic determinants of resistance can be transferred to other local pathogens

* new vectors may facilitate transmission of local or introduced pathogens

Question 12

How do cultural changes and changes to agricultural practices add to EIDs?

Answer 12

* Rapidly expanding global population and increased demand for animal protein in developing countries with rising incomes is driving increased production of meat and other animal food products WHICH contributes to intensification of animal production systems: spread of infectious diseases, waste management problems & use of in feed antibiotics which adds to the emergence and spread of antibiotic resistance via the food chain, contaminated environment, resistance genes spreading between bacteria.

Question 13

How does enhanced disease surveillance and detection add to EIDs?

Answer 13

Improve methods of detecting pathogens- especially molecular methods such as PCR and DNA sequencing which contributes to the identification of new disease agents.

Question 14

What is the role of veterinarians in EIDs?

Answer 14

Emerging zoonoses- clinical veterinarians– protect themselves (PPE, hygiene, infection control), protein their staffa nd clients, disease detection and reporting, assist in outbreak investigation and control.

* also laboratory diagnosis and detection of disease agents, research e.g. vaccine developement, pathogenesis, epidemiology, policy development

Question 15

Impacts of EIDs. Specific example?

Answer 15

* Animal health and welface- animal illness, death, culling

* Human health- illness, death, psychological distress

* Economic impacts- direct- loss of animals, loss of production or indirect- associated industries, tourism

* Social impacts- loss of livelihoods, movement restrictions

* Trade restrictions- animals and animal products

* Environmental- carcass disposal, use of chemicals, PPE

* Political

** Specific example: FMD- 2001 in the UK. 2000 cases of disease. 10 million livestock culled. Control efforts focused on movement restrictions (animals and humans), culling and burning all animals near an infected farm (3 km). No vaccination used. Not a zoonotic disease but still psychological human impact.

Question 16

To describe the principles, methods and equipment involved in humane slaughter, including stunning and ‘sticking’

Answer 16

Stunning- water bath for chickens with electrical stunning, scissor tongs for pigs and sheep, non penetrative captive bold (especially for cattle)

Sticking

Question 17

To know the signs that indicate a stun has been effective (electrical stun)

Answer 17

* Tonic: animal collapses and becomes rigid, no rhythmic breathing, head is raised, forelegs extended and hind legs flexed into the body

* Clonic: gradual relaxation of muscles, paddling or involuntary kicking (can be severe at times), downward movement of eyeballs, urination and/or defecation

* Recovery: resumption of rhythmic breathing, response to painful stimuli, becomes visually aware, attempts to stand

Question 18

To describe the principles surrounding the structure and design of a modern abattoir

Question 19

To know the processes that take place in a modern abattoir

Answer 19

* Stunning prior to slaughter

* Abattoir design to minimize animal stress, maximize animal welfare

* Animal welfare in mind for transport, lairage (where they are rested on the way to slaughter), stunning, slaughter

* Design and protocols for food and worker safety

Question 20

To understand the relationships between animal welfare, food quality and food safety

Answer 20

* calm cattle= lack of adrenaline which makes tough meat, dark cutters, bruising (cannot be used for food)– minimizing stress and physical damage

Question 21

Reversible stunning methods vs. irreversible– examples?

Answer 21

* Reversible- animal is able to recover sensibility. The brain function must be stopped by other means- severing blood vessels carrying blood to the brain. The period of insensibility needs to continue until death supervenes.

* reversible examples: CO2 stunning, non penetrative captive bolt, head only electrical stunning (electrodes must span the brain- used for small livestock)

* Irreversible stunning- animal will die if not slaughtered but sticking is still performed so that the animals are bled out before further processing to guard against unexpected return to sensibility following stunning

* Irreversible examples: head-to-back electrical stunning (epileptiform seizure and secondly fibrillation of the heart- loss of heart functionality and therefore blood stasis and reduced oxygen supply to the brain– small livestock), penetrative captive bold (passes between the cerebral hemispheres and hits the region above the hypocampus = massive disruption of all areas of the brain- often used in cattle)

Question 22

Signs of an effective stun using captive bolt (penetrative or non-penetrative)

Answer 22

* animal drops immediately and stays down

* uncoordinated hind leg movements- kicking

* no corneal (blink) reflexes

* cessation of rhythmic breathing

* no vocalization

* no rotation of the eye ball

* no coordinated attempts to rise

Question 23

What is CO2 stunning?

Answer 23

Currently used for pigs– 80-90% CO2- pigs lose consciousness within 30 seconds- can be some struggling or excitement within 30 seconds

** with poultry mixture of CO2, nitrogen, and argon

Question 24

What is the most effective method of bleeding?

Answer 24

Chest stick- faster bleed out

** must sever the blood vessels close to the heart in cattle and pigs

Question 25

What would happen if you severed the carotid arteries 5 seconds after stunning a cow?

Answer 25

\* the stun would render the cow insensible for 45 seconds but severing the carotid arteries only would take 90 seconds for the cow to become insensible-- therefore there would be a time where the animal was sensible and feeling pain

Question 26

Good abattoir design

Answer 26

\* Abattoir design is informed by animal behaviour \* Good management and staff training is essential \* Good animal welfare and good meat quality are linked \* Good restraint systems are needed for effective stunning \* Kicking on the line after stunning does not indicate a return to sensibility \* Attention to small details is vital \* animal welfare auditing is important \* curved- can't see what is up ahead \* move in small groups \* will head towards light \* non-slip floors \* 75% full pens

Question 27

How does flow work in an abattoir?

Answer 27

Lairage--\>kill floor--\> skinning & eviceration--\> offal room OR hide room OR chiller--\> boning room--\> freezer

Question 28

What are the exits in an abattoir?

Answer 28

Offal, hides and skins, whole carcase from the chiller, fresh cuts from the boning room, and frozen cuts from the freezer

Question 29

What are the percent breakdown of retail value of products?

Answer 29

5% hides, 80% meat, 9 % rendering/pharmaceutical product, 6% offal

Question 30

What are good design principles of lairage?

Answer 30

\* Non slip floors, curved races, high walls, minimal distractions, move animals in small groups, free access to water, room to lie down, keep animals of similar types together, ante-mortem inspection of all animals by veterinarian (AQIS), access to feed if held for prolonged period, facilities need to be easy to clean, animals should be protected from extreme weather conditions

Question 31

What are good design principles of restraint systems? What are two types?

Answer 31

\* important for achieving accurate placement of stunning devises and thus for achieving effetive stun \* removes the need to immobilize animals using other (inappropriate) methods 1. conveyer restrainers- pigs, sheep, cattle- for use with captive bolt or electrical stunning, large plants 2. stun boxes/ crush restrainers- cattle, captive bolt stunning

Question 33

Key design principles of conveyer restrainers-- when is this preferred vs. stun boxes?

Answer 33

Over 100 an hour this is better than a stun box

Question 34

What do meat consumers want?

Answer 34

1. Verification- the product needs to be consistent with what is on the label 2. quality- tenderness, juiciness, colour, flavour, shelf-life 3. Safety- no residues of antibiotics, hormones, anthelmintics, agricultural chemicals or pesticides, not derived from GMO 4. Helath promoting- nutritious, low in fat \*\* safe process for workers, animal welfare requirements met

Question 35

How does a facility minimize bruising?

Answer 35

\* no protruding or sharp objects, avoid animal slips trips and falls, appropriate stocking rates in trucks and yards, separate horned and polled animals

Question 36

What is the problem with ecchymosis?

Answer 36

\* cosmetic defect but also a higher pH which promotes bacterial growth \* hypertension or weak vessels + stress and excitement as well as some electrical stunning conditions, long stun to stick intervals, higher temperatures

Question 37

How do you avoid blood splash/ spotting/ echymosis?

Answer 37

\* minimize pre slaughter stress or excitement \* use optimal stunning conditions (optimise time, voltage for electrical stunning) \* minimize stun to stick intervals \* maximize efficient bleeding

Question 38

What is the problem with dark cutting beef? What is the ideal pH of meat?

Answer 38

\* Less glycogen at slaughter= less lactic acid= higher pH ideal pH is 5.4 to 5.7

Question 39

How do you avoid dark cutting beef?

Answer 39

\* Adequate nutrition on farm (feedlot cattle have higher levels of muscle glycogen, grazing cattle should be put at pasture at least 2-3 weeks before slaughter or should receive supplementary feed) \* Avoid physical and psychological stress (farm to slaughter)- good facilities, handling, procedures

Question 40

How does pale, soft, exudative pork arise?

Answer 40

\* Severe, acute stress just before slaughter in pigs \* accelerated rate of glycolysis just after slaughter while carcass temperatures remain high--\> excessive lactic acid--\> very low pH \* primarily food quality implication but resulting excessive drip loss could promote microbial growth

Question 41

How do you avoid PSE pork?

Answer 41

\* Keep pigs cool in hot weather and chill meat quickly \* Genetic selection of pigs that are not predisposed to PSE \* Reduce stress at the abattoir

Question 42

What are the key abattoir processes to preserve food safety? Which occur on the clean side and which on the dirty side?

Answer 42

1. ante-mortem inspection 2. post-mortem inspection 3. chilling

Question 43

What is the aim of the ante-mortem inspection? Major objectives?

Answer 43

To ensure that only apparently healthy, physiologically normal animals are slaughtered for human consumption and that abnormal animals are separated and dealt with accordingly \* major objectives: screen all animals destined to slaughter, proper rest and clinical info, separate diseased from healthy, animals in pain receive emergency slaughter, to ID reportable animals diseases, ID sick animals or any treated with drugs that should no longer be in the system (antimicrobials, chemotherapeutic agents, insecticides, pesticides)

Question 44

When does the ante-mortem inspection occur?

Answer 44

right after offloading

Question 45

Key points in a post-mortem inspection

Answer 45

Ensure meat is fit for human consumption. Carried out as soon as possible after dressing to detect any abnormalities. All organs and carcass portions kept together before they are inspected. The carcass is passed, trimmed, or condemned as appropriate

Question 46

Apply HACCP principles to relevant hazard

Answer 46

Contamination of meat with enteric bacteria (E. coli, Salmonella, Capylobacter) 1. Hazard analysis-- slaughter process, dressing and processing of carcass, and inappropriate handling of the product 2. CCPs and 3. Establish critical limits- CCP1 primary meat inspection (no visible signs of fecal material on the carcasses- zero tolerance- absence or presence), CCP 2- chilling (reduce surface temperature of carcasses to 4C or below within 24 hours (deeep muscle temp 6-7C within 36 hours for beef, 16 hours for pigs, 30 hours for sheep) 4. Monitor the CCPs-- Meat safety inspection & check the checker; monitor surface and internal temperatures of carcasses each day 5. Establish corrective action-- What would happen if fecal contamination? Contaminated meat is trimmed and condemned, further training of staff, review inspection procedures, review infrastructure. What would happen if meat did not reach required temperature in time? Removed from production chain, review chilling procedures, review equipment/ infrastructure 6. Record keeping- written and maintained HACCP plan, all records generated during monitoring of each CCP, records of any deviations from CL and the corrective actions taken 7. Verification- Sampling and analysis (ESAM program- E.coli and Salmonella program- set number of carcasses randomly selected for swabbing e.g. 1 test per 1500 carcasses, swabs sent to lab for testing and bacterial enumeration)

Question 47

List the different types of agents that can cause food-borne disease and give some examples of each

Question 48

Know which foods are commonly associated with food-borne disease and why these foods are high-risk

Question 49

Describe the impact of food borne diseases on human health

Answer 49

\* GI symptoms, onset can vary from 30 minutes with S. aureus to several days with Campylobacter \* Other symptoms: Meningitis (Listeria monocytogenes), jaundice (hepatitis virus), paralysis (paralytic shell fish poisoning), Pregnancy or birth defects (L. monocytogenes), Hemolytic uremic syndrome- anemia, acute renal failure, thrombocytopaenia (E. coli O157:H7- shiga like toxin) \*\* Potential chronic sequelae: chronic joint disease (sterile)- autoimmune conditions following bacterial enteric infections e.g. Reiter's syndrome & Guillian- Barre syndrome- flaccid, ascending paralysis and autonomic nervous system dysfunction following C. jejuni (autoimmune condition)

Question 50

Describe how an investigation into an outbreak of food borne disease is conducted including investigations into point-source and cluster outbreaks of disease

Answer 50

\* Contain the outbreak: environmental investigation- inspect premises, supervise clean up, exclude staff who have been ill, review/ audit, sampling \* Epi investigation- evaluate the association between exposure and disease- questionnaires (3 day food history), cohort or case control study (ill and not ill) \* Laboratory sampling- food and faecal specimens- liase with other jurisdictions (OzFoodNet) \* Trace back of suppliers/ foods

Question 51

What are some common infectious agents of animlas that cause foodborne disease in humans?

Answer 51

\* Bacterial: Campylobacter jejuni, Salmonella, Clostridium perfringens, pathogenic E. coli (o517:H7), Listeria monocytogenes \* Parasites: Giardia duodenalis, Cryptosporidium parvum, Toxoplasma gondii, Trichinella spiralis, Taenia saginata, Taenia solium \* Prions: Variant Creutzfeldt-Jakob disease (rare only 200 cases) \* Viruses: Tick born encephalitis virus in milk

Question 52

What are some common infectious causes of food-borne disease due to contamination (food handlers, environment)? What are two ways food is contaminated?

Answer 52

Bacteria: Staphylococcus aureus Parasites: Giardia duodenalis, Cryptosporidium parvum Viruses: Norovirus, Enterovirus, Rotavirus, Hepatitis virus \*\* Faecal oral route of transmission (food handler) \* shellfish that filter and then store viruses from water contaminated with human sewage

Question 53

What are some examples of disease due to toxins or contaminants from the environment?

Answer 53

\* Shellfish poisoning- biotoxins accumulate because they filter feed \* Toxic metals: can accumulate in animals living in contaminated environment (mercury in fish) \* Mycotoxins: Toxins produced by moulds in animal feeds can remain in the food chain \* Chemicals: antibiotic residues, pesticides, agricultural chemicals

Question 54

What are common foods causing disease?

Answer 54

1. Undercooked or raw eggs, meats, shellfish, unpasteurized dairy- adequate heat destroys many pathogens e.g. mayonnaise, tiramisu, raw shellfish, raw/undercooked chicken 2. Minced meat products- modern methods of processing huge batches mean larger volumes can be contaminated & mincing exposes more of the meat to bacteria, temperatures in the center of a minced product can be insufficient during cooking 3. Foods that are incorrectly stored, handled or transported- below 4 C is suitable

Question 55

Where can contamination of food arise?

Answer 55

At the abattoir during the slaughter proces and dressing and processing of carcass. Inappropriate handling of product once at the wholesaler--\> retailer--\> end user

Question 56

What bacteria can grow at 4 C? What are some high risk foods for this bacteria?

Answer 56

Listeria \*\* because these foods are served cold, they are high risk: pate, soft cheeses, cold meats, cooked diced chicken for sandwhiches, prepared and stored salads

Question 57

What bacteria is most commonly present in Australian eggs, what are we pleased is not here? Why?

Answer 57

\* Salmonella typhimurium- in AUS likely due to contamination on the surface of egg shells \* Salmonella enteritidis- worse because trans-ovarial transmission- more likely to be transmitted if the bacteria are inside the egg

Question 58

Recommendations for controlling Salmonella on farm?

Answer 58

Only Salmonella negative birds should enter the farm, biosecurity practices (people, rodent, wild bird control), effective egg grading (removing cracked and dirty eggs), vaccination, Salmonella free feed, effective egg washing, cleaning and disinfection practices

Question 59

List 3 Group A & 3 Group B diseases

Answer 59

Question 60

Who is required to notify in VIC of notifiable food borne disease?

Answer 60

Laboratory and Medical Practitioners

Question 61

What are point source outbreaks?

Answer 61

Question 62

What are cluster outbreaks?

Answer 62

Question 63

With a cohort study, when might it be used, how is it used?

Answer 63

\* Used in a point source outbreak \* exposure is a single event, assess risk of illness if exposed, ID which food risk factors are associated with disease, Strength of association Relative Risk- (RR)- the risk of getting sick if eaten X/ the risk of getting sick if not eaten X... e.g. A person is 4.2 times more likely to have become unwell if he ate X then if he didn't

Question 64

When is a case control study used? How is it used?

Answer 64

\* Commonly used when the setting of exposure is unknown, in a cluster investigation \* need a hypothesis \* assess food risk factors in cases and controls (not ill) (control selection is crucial to validity of study) \* Strength of association- Odds ratio: the odds that one had eaten X if ill/ the odds that one had eaten X if not ill \* A case has 4.2 times the odds of having eaten X than a non case

Question 65

What is a confidence interval? What is the P value? What does statistical significance depend on?

Answer 65

CI : Range within which 95% of times the true value of the estimated association lies e.g. OR = 4.2: 95% CI 2.2- 8.3 \*\* P value: Probability that an association at least as strong as that observed might have arisen by chance alne e.g. OR: 4.2: 95% CI 2.2- 8.3, p= 0.005 \*\* Statistical signficance depends on: The magnitude of difference between groups; the number of people in the study

Question 66

What is Bias and misclassification?

Answer 66

\* Recall bias \* Incorrect case / control ascertainment

Question 67

What is confounding?

Answer 67

Foods eaten together can often confound associations; stratification to control

Question 68

What is multivariate analysis?

Answer 68

\* Used in foodborne studies where cases eat similar items and multiple foods have statistically significant associations with illness; control for many factors at once

Question 69

What is the purpose of providing data of likely causes of outbreaks?

Answer 69

\* inform policy, primary production standards, educate food handlers, educate food inspectors/ EHOs

Question 70

What is the OzFoodNet?

Answer 70

\* Surveillance and investigations of foodborne disease outbreaks in Australia in conjunction with jurisdictions

Question 71

What are some factors in egg contamination?

Answer 71

\* dirty eggs, cracked shells, floor eggs, incorrect washing (temp, concentration, and water quality), infrequent egg collection especially during summer, no or insufficient egg refrigeration \*\* newly hatched chicks are highly susceptible to Salmonella colonization in their gut, Salmonella infection in adult poultry is often subclinical, flocks might be infected by more than one type of Salmonella, Salmonella often has a wide host range and can persist in the environment for long periods of time

Question 72

Short term and longterm fixes to Salmonella outbreak?

Answer 72

Short term: farm quarantined, all eggs to be graded and washed in an approved facility until farm own facility is upgraded to an acceptable standard Long term: all replacement pullets to be vaccinated with autogenous vaccine and tested prior to placement, organic acids to be incorporated in feed, biosecurity program updated, water filtration and chlorination to be installed, samples to be collected and tested frequently, Farm to develop its own Salmonella response plan

Question 73

What is the role of the Department of Health and Human services in a Salmonellosis outbreak?

Answer 73

Diagnose Salmonellosis and epi investigation, notify DEDJTR about suspected farm, monitor and upgrade food handling protocols in food premises

Question 74

What is the role of DEDJTR in a Salmonellosis outbreak traced by to a farm?

Answer 74

Dept of Economic Development, Jobs, Transport, and Resources \* key functions brought together that drive economic development \* Evaluation of farm compliance with egg standard, samples collected on farm, development and monitoring the implementation of the response plan, impose and lifting a farm quarantine order

Question 75

Describe the benefits and risks of vaccination, the beliefs and dangers associated with anti-vaccination sentiments

Answer 75

\* Benefits: enabled control of many diseases in both humans and animals eg. Smallpox and Rinderpest eradication \* Protection is not complete, adverse effects, many vaccines require herd immunity to be effective, some are expensive \* Anti-vaccination sentiments-- vaccinations a victim of their own success and dissemination of misinformation via internet e.g. Wakefield study and sharp drop in vaccination rates in the UK associated with significant increase in measles and mumps deaths and severe injuries--- risks to individuals not vaccinated, risk to community without herd immunity, vaccination can help reduce R0 \< 1, danger to those who cannot be vaccinated (very young, elderly, immune suppressed)

Question 76

Demonstrate an understanding of the epi of influenza

Answer 76

\* Type A influenza infect birds and mammals (humans too)-- associated with all pandemics (seasonal epidemics) \* generally from birds or pigs- amplifier host which spreads widely due to naive popultion to new virus \* Generally severe disease in very young, old, and immunocompromised but occasionally like 1918 it can primarily cause disease in young adult population due to strong immune systems and cytokine storms (2009 swine flu was the same) \*\* concern is always a reassortment or mutation that can transmit person to person that is highly pathogenic Control measures: vaccination (mainly against HA, updated every year or so), disease containment (isolation, quarantine, social distancing, physical barriers, hand and personal hygiene, use of PPE by healthcare workers), antivirals \*\* But cannot predict the strains, 4-6 month delay before vaccine strains can be characterized and grown up in bulk, leaves the population vulnerable in the early stages of a pandemic \*\* WHO decides which strains- meet twice annually

Question 77

Describe the pathogenesis of Ebola

Answer 77

\* entry through mucous membranes and broken skin, infectious dose 1-10 particles, saliva, tears, breast milk, faeces, semen, urine \* propagation generally involves intimate contact \* non specific flu like symptoms of fever, myalgia, malaise--\> GI bleeding, rash, haematological irregularities such as lymphopenia and neutrophilia, cytokines contribute to inflammatory response, damage to the liver combined with massive viraemia = DIC \* CFR- 50-90%

Question 78

Epidemiology of ebola

Answer 78

\* Bats as reservoir host for ebola viruses (Ebola, Sudan, Tai Forest, Bundibugyo, Reston virus-non human)-- endemic cycle within bat populations \* epidemic cycle. Bats--\> primates--\> other mammals--\> humans \*\* there are populaton rsk areas-- predicted distribution due to bat habitat, elevation, etc.

Question 79

How can Ebola be handled safely in a laboratory setting?

Answer 79

Classified as a Level 4 agent on the basis of a high CFR and absence of therapeutics or vaccines \* Do not mouth pipette, restricton of needles and syringes, avoid spills and production of aerosols by being careful, use PPE, wash hands, decontaminate, do not eat drink store food or smoke in the lab \*\* PC4- handling of highly dangerous pathogens to personnel and environment that might cause lethal disease with no treatment options \*\* Class II cabinet- with HEPA filter for air (PC 2-4), biologiacl waste- holding tank with chemical treatment then sterilization (autoclave)

Question 80

What are the molecular approaches to detection of Ebola and other related viruses?

Answer 80

Ebola Real- Time PCR, Ebola Conventional PCR \* Viral RNA extraction performed in PC 4 containment, all subsequent steps are performed at PC2

Question 81

describe how influenza activity is monitored and describe the control measures that can be used for seasonal and pandemic influenza

Answer 81

WHO monitors via the Global Influenza Surveillance and Response System \*ID and monitor influenza viruses circualting in human population, monitor antigenic drift, monitor emergence of seasonal virus variants resistant to antiviral drugs, make annual recommendations on composition of influenza vaccines, early detection of unusual influenza viruses in human population (= pandemic potential)

Question 82

What samples are taken to detect influenza?

Answer 82

Question 83

What is detected and what tests are used to detect influenza?

Answer 83

Question 84

What are the basic components of a PC4 lab?

Answer 84