Public Health- Final

Name (print): _____________________________ Sign: _____________________________ Public Health Issues Fall 2018 – open

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book/note Part I Applications – 220 points All of the information required for this exam has been presented this semester. Refer to course modules to include your class notes, power points, assignments, readings, CDC website. Consider this part to be a study guide for Part II. • • • • Bring to exam as printed responses (preferred) or if printer not available, legible written responses – YOU MUST INCLUDE THE QUESTIONS WITH YOUR RESPONSES. Place responses in the exam envelope with Part II. Do not send these responses by email – they will not be accepted. If not in the envelope, you lose the points. I will not be contacting you if I find that this section is missing. Set A: Required Questions – each of the following questions are required – 175 points in this section Question 1 – Infectious Diseases in the 21th Century (35 points – note breakdown) • • • • What is unique about infectious diseases? (5) Citing at least five examples, describe how far we have come in the U.S. with respect to public health achievements in infectious diseases through the 20th century. (10) A number of challenges remain today with respect to control/prevention/eradication of infectious diseases; eg, emerging infectious diseases, vaccine-preventable diseases, water and foodborne diseases, antibiotic resistance, multistate outbreaks, etc. Describe ONE of these issues in depth using examples. (10) Briefly describe factors that affect whether or not outbreaks spiral out of control. Examples: In 2014, Senegal and Nigeria managed to contain Ebola cases to a few but in West Africa, the outbreak increased exponentially, rapidly becoming pandemic; in 2018, the number of cases of Ebola in DRC increased dramatically in spite of availability of novel vaccine and antiviral treatments (10) Question 2: Outbreaks (60 points – note breakdown) – use bullets/outlines/tables where applicable • • • • • Cite reasons for why investigation of an outbreak important? (5) What are the steps involved in investigating outbreaks? Discuss why each of these steps is important. You may use a table to organize your information. (10) Refer to any one case study from the textbook. Using the steps you outlined above, show how the case was investigated (Note: Be concise – use an outline or table) (20) Give one or two specific examples of how ‘pseudo-epidemics’ can occur. What are the consequences? How can pseudo-epidemics be avoided? (10) What is the role of the local public health department in surveillance, outbreak investigation, and control/prevention of infectious diseases? What is the role of the state department of health? What is the role of CDC? (15) Question 3: Investigating Outbreaks (30 points – note breakdown) • • In reading the personal accounts of outbreak investigations in the textbook, what common elements did you observe? Give specific examples of ways in which investigators had to ‘think outside the box’ (that is, the ‘box’ being the ‘steps involved in outbreak investigation’). (15) What did you learn from the investigators that might help you if you were to find yourself in the position of having to investigate a major outbreak? Provide examples. What kinds of factors might you encounter that would have to be dealt with? (15) Question 4: Disease Transmission (50 points – note breakdown) – use bullets/outlines/tables where applicable • • • • • Describe at least five mechanisms of transmission of infectious diseases. Give at least one example of each (10) Describe factors that lead to increased susceptibility to infectious diseases. Describe at least five different factors and tell why/how they lead to increased susceptibility. (10) What is meant by in incubation period? Using the example of Ebola: what is known about the incubation period, how is the disease transmitted, how would you evaluate whether or not a person should be quarantined and for how long? (10) Why are patients in healthcare facilities (eg, hospitals, assisted living, long-term care, rehabilitation, etc.) at greater risk of acquiring infectious diseases and at increased risk of mortality due to infectious diseases? (10) What is R-naught? Give examples of several infectious diseases to include influenza, Ebola, SARS, measles, mumps, and pertussis and their respective R-naughts. What is herd immunity and what is its significance? How is the percent required to vaccinate relate to R-naught? (10 points) Set B: Question Options – choose ONE option in EACH of the following questions – 45 points in this section Question 5: One Health, Zoonoses, Globalization, Climate Change, and Emerging Infectious Diseases (each is worth 20 points) Option A: • • Illustrate the “ONE HEALTH” concept and describe factors involved. What is the significance of the One Health concept? (10) Describe factors that enhance opportunities for microbes to cross species lines. Include examples. (10) Option B: • What is an emerging infectious disease? Give a specific example of an emerging infectious disease and describe factors that have allowed emergence of the disease. (10 points) • Define zoonotic infections and tell why they are significant. Give an example of a zoonotic infection. (10) Option C: • What are the effects of globalization and climate change on health, with an emphasis on infectious diseases? Cite specific examples (20) Question 6: Social / Cultural / Ethical Issues in Infectious Diseases (each is worth 25 points) Option A: • In the course, we studied how social/cultural factors affect transmission of infectious diseases and that conversely, infectious diseases have social/cultural consequences. Use one or more of the examples used in the course (eg, Black Death-Plague, Tuberculosis, HIV) to illustrate this from historical / contemporary perspective. Option B: • Ethical issues in infectious diseases include quarantine and isolation, clinical trials of vaccines and treatments, etc. Sometimes, effects of unethical trials can have lasting effects on populations targeted in such studies, Use one or more of the examples used in the course (eg, syphilis, HIV/AIDS) to illustrate an ethical issue.
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