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Why is the human body a hospitable site for bacteria to grow and flourish?

Because of its sufficient nutrients and appropriate condition of temp and humidity


What is a symbiotic relationship?

Both humans and microorganisms benefit


What is an example of a symbiotic relationship?

Normal flora of the human gut are provided nutrients from food and in exchange produce enzymes that facilitate digestion and use of more complex molecules found in the human diet, provide antibacterial factors that prevent colonization by pathogenic microorganisms, and produce usable metabolites (vit k)


What are possible strategies of microbial treatment to limit antibiotic resistant strains?

consistent, proper hand hygiene, maintenance of a clean environment, use of barrier where appropriate, and prompt identification of patients at high risk of colonization with transmissible microorganisms.


What is the prevention strategy for the US to address emerging infections?

Surveillance & response, applied research, Prevention and Control, and Infrastructure


What is the role of surveillance and response ?

detect promptly, investigate, and monitor emerging pathogens, the disease they cause, and the factors influencing their emergence


What is the role of applied research?

integrate lab science and epidemiology to optimize public health practice


What is the role of prevention and control?

enhance communication of public health info about merging diseases and ensure prompt implementation of prevention strategies


What is the role of infrastructure?

strengthen local, state, and federal public health infrastructures to support surveillance and implement prevention and control programs


Give examples of emerging infections

West Nile Virus, SARS, Influenza, Hanta Virus, Resistant Microbes, and Influenza A/H1N1 - 2009


When and where did WNV emerge?

NY in 1999


WNV has moved from NY to _____?

almost all of the continental U.S., 7 Canadian provinces, and throughout Mexico and parts of the Caribbean


What is the etiology of WNV?

infected mosquito & infected bird, transfusions, transplants, maternal-child. Not through touch (contact) or airborne


True or False, most people with WNV are asymptomatic ?

TRUE, 70 to 80% are asymptomatic


What are the clinical presentations of WNV?

Fever, headache, fatigue, skin rash on trunk, swollen lymph glands, and eye pain


What are the 3 severe forms of the WNV?

West Nile (WN) Meningitis, WN Encephalitis, WN Poliomyelitis


When the CNS is affected, what are 2 clinical presentations?

febrile headache and encephalitis


What does SARS stand for?

Severe Acute Respiratory Syndrome


Describe the impact that SARS has had locally and globally

originated in Southern China in end of 2002, crossed into Hong Kong in Feb 2003. In days, it lead to Viet Nam, Singapore, Canada, Germany, and beyond. Nov 2002 to July 2003, more than 8,098 SARS cases, 774 deaths in 26 countries ( majority in the Western Pacific)


What are the clinical Presentations of SARS?

high fever, headache, discomfort, body aches, mild respiratory symptoms at outset, diarrhea, a dry cough, and pneumonia


What are the 3 types of Influenza?

Seasonal/ Common flu, Avian Influenza (or bird) flu (AI),and Pandemic Influenza


Describe the difference between Seasonal and Pandemic Influenza

Season flu is a resp. illness that can be transmitted person to person. Most people have some immunity and a vaccine is readily available. Pandemic influenza is a virulent flu that causes a global outbreak/pandemic of serious illness. Because there is little natural immunity, the disease can spread easily from person to person


What is the Avian Influenza caused by?

it is caused by influenza viruses that occur naturally among wild birds


True or False, low pathogenic AI is deadly to domestic fowl and humans

False, Highly pathogenic is deadly, whereas Low pathogenic AI is common in birds and causes few problems


Which subtype of AI are healthcare providers most concerned with and why?

H5N1 b/c its virulent, is being spread by migratory birds, can be transmitted from birds to mammals & humans, and the virus continues to evolve. Since 2003, there have been numerous cases reported, but no human to human contact YET.


What are the clinical presentations of Avian Influenza?

fever, cough, sore throat, muscle aches, eye infections, pneumonia, acute respiratory distress, viral pneumonia


What is another name for Hanta Virus?

Hanta Pulmonary Syndrome (HPS)


What is HPS and how is it contracted?

HPS is a potentially deadly disease transmitted by infected rodents through urine, droppings, or saliva. Humans can contract the disease when they breathe in the aerosolized virus


Describe the impact Hanta Virus has had locally and globally

First recognized in 1993 and has since been identified throughout the U.S. Outbreaks of hantaviral disease have been associated with changes in rodent pop. densities, which may vary across time, both seasonally and from year to year


What are the clinical presentations of HPS?

Fever, myalgia, N&V, cough, dizziness, arthralgia, SOB, rhinorrhea, and sore throat


MDR TB, MRSA, VRE, VISA, And VRSA are all examples of what?

Resistant Microbes


______ can lead to the destruction of the normal flora, allowing the selective overgrowth of antibiotic-resistant strains of pathogens that had previously been kept under control

Overuse of antibiotics


True or False, 3.7% of new cases and 20% of previously treated cases are estimated to have MDR-TB

True. 3.7% of new cases and 20% of previously treated cases are estimated to have MDR-TB


Extensively drug-resistant TB (MDR-TB plus resistance to second-line injection) has been identified in how many countries?



E.coli O157:H7 was first recognized as a cause of illness in 1982 during an outbreak of _________

severe blood diarrhea


What was the source of contamination of the E.coli outbreak in1982?

Undercooked ground beef


Describe some of the recent E.coli outbreaks

package spinach source, raw clover sprouts, and a beef E.Coli outbreak in 2009


What does a phase 6 declaration mean?

a global pandemic


Describe the impact that Influenza A/H1N1 had on the world in 2009

43-83 million H1N1 cases,192,000 - 398,000 H1N1 hospitalizations, and 8,720-18,050 deaths


True or False, Influenza has been completely eradicated worldwide

False, the disease does not go away, it comes back and can not be contained to one geographic area


A patient wants to know when the flu season begins and ends. What should you tell them?

The flu season starts in October or November and peaks from December to March


How might you educate a patient on the transmission of Influenza?

It is spread person to person via small particle aerosols that can get into the respiratory tract. It can survive on surfaces for small amounts of time and can be spread this route if it gets into the nasal mucosa before it loses its infectivity


A patients comes into your community clinic presenting with the following signs and symptoms... Fever, myalgia, headache, ocular symptoms, dry cough, and nasal discharge. What is most likely the diagnosis?

Uncomplicated Influenza A


What are the Pulmonary Complications, Sequelae seen in Influenza A?

Croup in children (a cough that sounds like a seal, difficulty breathing, stridor), primary influenza virus pneumonia, and secondary bacterial infections


What are the non-pulmonary complications associated with Influenza A?

cardiac failure, encephalopathy, Reyes Syndrome, Guillain-Barre Syndrome


Define Attenuation

The weakening of a microbe so that it can be used in a live vaccine


What is a conjugate vaccine?

a vaccine in which proteins that are easily recognizable to the immune system are linked to the molecules that form the outer coat of disease-causing bacteria to promote an immune response


True or False, conjugate vaccines are designed only for adults over 18

False, conjugate conjugate vaccines are designed primarily for very young children because their immune systems can not recognize the outer coats of certain bacteria


What is a DNA/Naked DNA vaccine?

a vaccine that uses a microbe?s genetic material, rather than the whole organism or its parts, to simulate an immune response. (Tb, SARS, HIV)


What is an inactivated "killed" vaccine?

a vaccine made from a whole viruses or bacteria that has been inactivated with chemicals or heat


______ is a vaccine that uses one or more components of a disease-causing organism, rather than the whole, to stimulate an immune response

Subunit vaccine


What is the technique by which genetic material from one organism is inserted into a foreign cell or another organism in order to mass-produce the protein encoded by the inserted genes called?

Recombinant DNA Technology


_______ is a vaccine made using recombinant DNA technology to engineer the antigen molecules of the particular microbe

Recombinant Subunit Vaccines


True or False, vaccines that use modified viruses or bacteria to deliver genes that code for microbial antigens to cells of the body are called Toxoids

False. Correct answer is Recombinant Vector Vaccines.


Diphtheria and tetanus are notorious examples of what?



What is the controversy surrounding toxoids?

The growth of the bacterium is not dangerous, but the protein toxin that is liberated by it is. Treating the toxin with, for example, formaldehyde, denatures the protein so that it is no longer dangerous, but retains some epitopes on the molecule that will elicit protective antibodies.


What is the Diphtheria vaccine?

is an inactivated form of diphtheria toxin (toxoid); part of DTap


True or False, H. influenzae type b (Hib) vaccine is an extracted bacterial antigen conjugated to a protein carrier



What type of vaccine is used for Hep A?

inactivated virus


What type of vaccine is used for Hep B?

recombinant viral protein


What type of vaccine is used for Influenza?

injected inactivated virus


Which vaccines are attenuated live viruses, part of MMR combined vaccine?

Measles & Mumps


True or False, the polio vaccine us an inactivated toxin & contains other bacterial agents and is part of Dtap combined vaccine

FALSE. Correct answer is Pertussis, Whooping Cough


What is the difference between the children and adult Pneumococcal vaccine?

Children: vaccine is a protein conjugate with 7 different capsular antigens; Adult: vaccine is a mixture of 10 extracted capsular polysaccharides


True or False, the polio vaccine is an activated virus

False, the polio vaccine is an inactivated virus vaccine


The Rotavirus and Varicella Zoster (Varicella) vaccine are both examples of what kind of vaccine?

Attenuated live virus


Rubella is apart of which combined vaccine?

MMR combined vaccine


Which vaccine contains the live vaccine virus?



____ vaccine is an inactivated from of the ____ toxin (toxoid) and is apart of what?

Tetanus, Tetanus, DTAP


Describe medical issues surrounding vaccines

possibility of eradicating infections, pain and redness at injection site, fever, allergic reactions to vaccine ingredients, infection associated with attenuated viruses in immondeficient individuals.


What is thimerosal and why is it a concern regarding vaccines?

It is a mercury containing compound that has been used as a preservative in vaccines. Has been removed from all vaccines in 2001, with the exception of the influenza vaccine.


Describe the political issues surrounding vaccines

Controversies over the efficacy, safety, and morality of compulsory immunization stem from the longstanding tension between two, sometimes divergent, goals: protecting individual liberties and safeguarding the public?s health


Describe the economic issues surrounding vaccines

Every dollar spent on immunization saves 6.30 in direct medical costs, with an aggregate savings of 10.5 billion. When including indirect costs to society -- a measurement of losses due to missed work, death and disability as well as direct medical costs -- the CDC notes that every dollar spent on immunization saves 18.40, producing societal aggregate savings of 42 billion


Identify 5 substances used in bioterrorism

Anthrax (Bacillus anthracis), Smallpox (variola major), Botulism (clostridium botulinum toxin), Plague (Yersinia pestis) E. coli, water safety threats (cholera), emerging infectious diseases (Hanta virus)


After a major disaster, what are some acute physical issues your patient may present with?

gastroenteritis or viral syndromes


True or False, More than one half of acute post-disaster health issues are illnesses

True. Ex: self-limited viral syndromes (i.e. pneumonia, diphtheria, colds), gastroenteritis


Approximately ____ of acute post-disaster health complaints are injuries (cuts, abrasions, sprains, fractures)



True or False, routine items post major disasters include refills, wound checks, and splinting



Describe acute mental issues post major disasters

emotional liability, negative emotions, cognitive dysfunction & distortions (reduced concentration, confusion), physical symptoms (headache, tension, fatigue), and behaviors negatively impacting interpersonal relationships ( irritability, distrust, withdrawal)


When will acute psychological distress resolve?

weeks to several months, can persist up to one year