Exam 1 Flashcards
Traditional medicine focuses on ________ patient health while Public Health focuses on the effects of disease on _________.
individual
populations
COVID-19 is a zoonosis which mutated and transferred to humans from:
horseshoe bats
Flesh-Eating Bacteria etiology is _______ _______.
Vibrio vulnificus
Flesh-Eating Bacterial infections are associated with increased:
water temperatures (climate change)
How is Vibrio vulnificus transmitted?
contaminated seafood
What disease uses humans and horses as a dead-end host and transmitted by mosquitos primarily in the Gulf Coast States?
Eastern Equine Encephalitis
Sudden headache, fever, chills, and vomiting are signs of Eastern Equine Encephalitis. Severe infections cause ________, ________, and ________.
disorientation
seizures
coma
Legionnaire’s Disease is caused by _________.
Legionella
Legionella causes severe _________, especially in immunocompromised hosts.
pneumonia
What outbreak location is Legionnaire’s Disease associated with?
Fletcher State Fair
Which bacteria is normal in healthy dogs and cats but can cause necrotic wounds in humans via licking/biting?
Capnocytophaga canimorsus
Which bacteria is associated with food-borne disease in weakened immune systems via an outbreak of contaminated milkshakes?
Listeria
Which disease is a common worldwide public health concern do to vaccination controversy in association with Autism and decreased vaccination rates?
Measles
(T/F) Food-borne illnesses are a major issue in the US.
True (high economic costs)
When a food pathogen replicates in the GI tract and causes signs within 24-48 hours, this is called:
infection
When a bacterial toxin is ingested in food and signs develop within minutes to hours, this is called:
intoxication
What is the most common sign of food-borne illness?
diarrhea
What is the definition of diarrhea?
3+ liquid stools per day
Which pathogen is the most common cause of food-borne diarrhea?
E. coli
What are the 3 clinical types of diarrhea?
- acute watery
- acute bloody (dysentery)
- persistent (>14 days)
Which gram-negative, rod-shaped bacteria is part of the normal GI flora but some cause disease?
E. coli
Some E. coli can cause ________ or _______ illness.
diarrhea
respiratory
List the 6 pathotypes of Diarrheagenic E. coli.
- Shiga-toxin producing E. coli
- Enterotoxigenic E. coli
- Enteropathogenic E. coli
- Enteroaggregative E. coli
- Enteroinvasive E. coli
- Diffusely adherent E. coli
Shiga-Toxin Producing E. coli (STEC) is also referred to as ______ or _____.
EHEC
VTEC
Which two toxins does STEC use?
shiga toxin 1
shiga toxin 2
Which shiga toxin used by STEC tends to be more virulent?
shiga toxin 2
What is the most common STEC infection?
E. coli O157
4 sources of Shiga-Toxin Producing E. coli infection include:
- species contact (cattle, goat, sheep, deer)
- contaminated food (beef, milk)
- stool (calves)
- person-to-person (daycares)
Incubation period for STEC.
3-4 days
STEC causes what life-threatening syndrome in 5-10% of patients due to RBC destruction and kidney failure?
Hemolytic Uremic Syndrome
(T/F) Hemolytic Uremic Syndrome due to STEC should be treated promptly with antibiotics to stop progression.
False (no treatment)
(T/F) Prevention, not treatment is the only way to avoid Hemolytic Uremic Syndrome.
True
(T/F) Washing food removes all STEC from food and therefore is a method for prevention.
False (only removes some - lowers dose)
Enterotoxigenic E. coli (ETEC) is the leading cause of:
Traveler’s Diarrhea
Which two toxins does Enterotoxigenic E. coli use?
heat-stable toxin (ST)
heat-labile toxin (LT)
How do heat stable toxin and heat labile toxins cause diarrhea in ETEC?
stimulate GI tract to secrete excess fluid
Incubation period of ETEC.
1-3 days
ETEC infection has a (good/poor) prognosis.
good
Children in developing countries can develop what long-lasting effects due to ETEC infection?
malnutrition, stunting, cognitive defects
Which country is most commonly associated with Traveler’s Diarrhea caused by ETEC?
Asia
How can ETEC be treated?
fluids
OTC meds prior to travel
Which pathotype of E. coli was the first strain found as a source of outbreaks in the 40s and 50s and is called “Summer Diarrhea” in infants of developed countries?
Enteropathogenic E. coli (EPEC)
(T/F) EPEC is a major problem in developed countries.
False
(T/F) Enteroaggregative E. coli only causes major infection in developing countries.
False (both developing + developed)
Enteroaggregative E. coli is the second most common cause of:
Traveler’s Diarrhea
Which E. coli pathotype is associated with a German outbreak in 2011 through sprouts?
Enteroaggregative E. coli (EAEC)
Which pathotype of E. coli is endemic in developing countries due to poor sanitation but rare in developed countries and is similar to STEC genetically?
Enteroinvasive E. coli (EIEC)
Any outbreak of foodborne illness is defined as:
2+ cases from single food item
The majority of food-borne illnesses are caused by ________ while fewer illnesses but more deaths are caused by ________.
produce
meat/poultry
_______ causes the most deaths due to Food-borne illness.
poultry
List 2 possible causes of poultry-related deaths.
Listeria
Salmonella
_______ _______ prevents diseased meat from reaching consumers.
meat inspection
(T/F) Meat inspection is required by law.
True
Meat Inspection uses 7 HACCP Principles. What does HACCP stand for?
Hazard Analysis & Critical Control Points
______ or _____ notify companies when there is a problem and evaluation for a recall.
USDA + FDA
(T/F) Recalls are part of fairly new food inspection procedures.
False (old - lacked authority)
Current regulations for food safety include the USDA for _______ and FDA for _______.
meat/poultry
other (seafood, juice, eggs)
Which Act is a current food regulation since 2011 that states the FDA can order food recalls instead of relying on industry cooperation?
FDA Food Safety Modernization Act
Regarding antemortem food inspection, match the class to its description:
- acceptable for slaughter
- may have disease
- does not go to slaughter
- passed
- suspect
- condemned
What are the 5 D’s which condemn an animal during antemortem inspection?
dead, dying, diseased, disabled, drugged
Condemned food products are disposed properly via _________, meaning they are cooked at high temperatures to destroy organisms and only used for inedible purposes.
tanking
(T/F) Meat is likely to be sterile after processing and when reaching the consumer.
False (not likely to be sterile)
Food Irradiation is the process of using ______ _________. A high level of radiant energy penetrates food to kill microorganisms.
cold pasteurization
(T/F) Food irradiation kills bacteria at high doses but DOES NOT completely sterilize food.
True
Canned pet foods must be processed with low ______ regulations so food is free of microorganisms.
acid
(T/F) Pet food must be pre-approved by the FDA.
False! (no requirement for pre-approval, just need safe ingredients)
Which corporation regulates pet food safety?
FDA
“A product intended for consumption for pets manufactured under FSIS voluntary reimbursable inspection services” is the definition of:
certified pet food
For certified pet food, ______ inspects, certifies, and identifies pet food. _____ regulates other pet food subject to FFDCA.
FSIS
FDA
What decree, revised in 2017, identifies quality standards for milk, regulating producers, creameries, and veterinarians and are enforced by State Milk Inspectors?
Pasteurized Milk Ordinance (PMO)
There are 3 classes of milk according to milk regulations. Match the class to the description:
- visible color, odor, or texture change
- unknown suitability before milking
- unfit for human consumption after veterinary treatment
- abnormal milk
- undesirable milk
- contaminated milk
What are the 2 overarching ways that pathogens enter milk?
- mastitis
- contamination
_______ pathogens can enter milk via mastitis, or inflammation of the mammary gland.
bacterial
Contamination can cause pathogens to enter milk via ________, _______, or _______.
fomites, poor handling, unclean cattle
What are some examples of milk adulterants due to cattle treatment?
biologics (vaccine), hormones, antibiotics
What is an example of an environmental adulterant that can be added to milk?
pesticides
Regarding milk storage, milk must be (frozen, chilled, heated) and water (added/not added).
chilled
not added
_______ _______ testing is used to detect bacterial growth inhibitors, somatic cell count, and bacteria count in milk.
bulk tank
Term for the heating of all milk particles to a specific temperature or for a specific timeframe without recontamination.
pasteurization
Pasteurization of milk is used to kill pathogens and enhance shelf-life. Which important pathogen is killed via Pasteurization?
Coxiella burnetti (causes Q-fever)
List the 3 Pasteurization methods.
- Low-Temp-Long-Time (LTLT)
- High-Temp-Short-Time (HTST)
- Ultra-High Temp (UHT)
Ultrapasteurization of milk requires _____ degrees F for at least what amount of time?
138 F for 2 seconds
(T/F) Ultrapasteurized milk can be stored without refrigeration for months.
True
List 3 pathogens which are of concern in raw milk.
- campylobacter
- E. coli (STEC)
- salmonella
Which disease causes large volumes of watery diarrhea and significant morbidity AND mortality in poverty?
Cholera
Etiology of Cholera
Vibrio cholerae
(Children/Adults) are more susceptible to Cholera.
children
(T/F) Cholera is endemic to US.
False (not anymroe)
(T/F) The GI tract retains normal absorptive properties during Cholera infection.
True
How is Cholera transmitted?
fecal-oral (contaminated food/water)
Recent outbreaks of Cholera in 2017 and 2018 occurred in _______ and ______.
Haiti
Yemen
What is the main treatment for Cholera?
oral fluids
How is Cholera prevented?
vaccination (Vaxchora)
prevents severe disease prior to travel
Who studied the cholera outbreak in London?
John Snow
What was the source of the Cholera outbreak in London determined by John Snow?
broad street pump
Gastroenteritis which increases infections during warmer months, is caused by Vibrio _________.
Vibrio parahaemolyticus
How is Vibrio parahaemolyticus transmitted?
contaminated seafood
Between 2011-2018, Vibrio parahaemolyticus outbreaks occurs in which two locations in the US due to contamined seafood?
Seattle
Texas
Washington DC
Vibrio _________ is similar to V. parahaemolytica but is mainly an issue in immunocompromised individuals with chronic liver disease, causing septic shock, blistering, and 50% fatality?
Vibrio vulnificus
(T/F) Vibrio vulnificus infection is rare but underreported.
True
Which bacterial pathogen is zoonotic and causes diarrheal illness in the US, often with sporadic and isolated outbreaks?
Campylobacter
The majority of those who develop diarrheal illness due to Campylobacter will recover without treatment, but some can develop severe disease and signs such as:
meningitis, UTI, septicemia, reactive arthritis
Guillain-Barre Syndrome
Campylobacter is found in the normal flora of:
poultry
Campylobacter has (high/low) morbidity and (high/low) mortality.
high
low
(T/F) Campylobacter can be transmitted from pets to humans.
True (esp. small children)
Yersiniosis is a food-borne gastrointestinal disease caused by Yersinia ________.
enterocolitica
Yersinia enterocolitica causes fever, ________ abdominal pain, and often bloody diarrhea.
right-sided
Yersiniosis is most common in:
young children
Which species is the main animal host for Yersinia enterocolitica?
swine
Which opportunistic gram-positive cocci causes skin infections?
Staphylococcus aureus
List 4 diseases that can develop due to Staphylococcus aureus.
- impetigo
- scalded skin syndrome
- toxic shock syndrome
- food poisoning
Impetigo is caused by a combination of staph and ______.
strep
Scalded Skin Syndrome by S. aureus is identified by growth on _______ ______.
umbilical stump
_________ toxin causes septicemia in Scalded Skin Syndrome.
exfoliative
Which disease caused by S. aureus is wound or tampon-associated classified by sudden fever, chills, vomiting, diarrhea, and is fatal in 5% cases?
toxic shock syndrome
What is the source of food poisoning caused by Staph aureus?
food handler (NOT usually animal isolates)
Food Poisoning due to Staph aureus causes disease via (infection/intoxication).
intoxication
What is the primary sign of Food Poisoning due to Staph aureus?
vomiting (rapid onset)
___________ staph aureus is associated with emerging strains in hospitals and veterinary clinic strains.
Methicillin-Resistant (MRSA)
What effect can cause MRSA to be spread back and forth between humans and pets?
ping-pong effect
_________ Staph aureus is the dominant livestock-associated MRSA strain, especially in which species?
ST398
swine
(T/F) ST398 Staph. aureus causes serious disease in humans.
True
Which food-borne pathogen is a gram-positive rod with peritrichous flagella that grows at refrigeration temperatures?
Listeria monocytogenes
Listeria monocytogenes from the soil or GI tract sources often contaminate _______ while feces contaminate ______.
deli meat
lettuce
There was a recent Listeria monocytogenes outbreak (2018) in:
South Africa
Listeriosis causes serious food poisoning in:
infants, elderly, immunocompromised
3 manifestations of adult Listeriosis.
meningitis
septicemia
endocarditis
Neonatal Disease or Granulomatous infantiseptica caused by Listeria can be transmitted _______ or during _______.
in-utero
vaginal delivery
Listeria uses _____ _____ to travel from cell to cell.
actin tails
Clostridium botulism causes Botulism which is an (infection/intoxication).
intoxication
The most potent toxin, ________, is produced by Clostridium botulinum.
neurotoxins
Major sign of Botulism.
flaccid paralysis
3 human disease forms of Botulism.
- foodborne
- wound
- infant
Botulism has what percent mortality rate?
100% (all forms)
Botulism neurotoxin is heat (resistant/sensitive).
sensitive (destroyed by boiling)
In 2015, Ohio was associated with a Botulism outbreak due to what source?
home-canned potato salad
Adult Botulism causes (infection/intoxication) and Infant Botulism causes (infection/intoxication).
intoxication
infection
Infant Botulism is associated with:
SIDS (sudden infant death syndrome)
Wound Botulism develops under (aerobic/anaerobic) conditions.
anaerobic
Wound Botulism is associated with:
black-tar heroin addicts
Botulism can be used as _______ since it can be aerosolized, easy for production, and lethal.
bioweapon
Botox from Botulism toxin is used two what two other treatments?
cerebral palsy
migraines
Clostridium perfringens causes which 2 diseases?
- food poisoning
- Enteritis necroticans (pigbel)
Enteritis necroticans is characterized by a hemorrhagic, inflammatory, or ischemic necrosis of the jejunum. It is specifically caused by which type of C. perfringens?
Type C
(T/F) Enteritis necroticans is often fatal.
True
(T/F) Enteritis necroticans is not uncommon in developing countries.
False (rare, occurs in developing)
How is Enteritis necroticans usually transmitted?
high protein meals (usually pork)
Bacillus _______ causes nausea, vomiting, and mild diarrhea.
Bacillus cereus
Bacillus cereus uses _______ toxin to cause vomiting while _______ is a pore-forming toxin which causes cramps and diarrhea.
emetic
enterotoxin
How is Bacillus cereus primarily transmitted?
rice dishes
(T/F) Shigella is a zoonotic bacteiral pathogen.
False (human pathogen only)
Shigella causes Shigellosis or _______ ________.
Bacillary Dysentery
How is Shigella transmitted?
fecal-oral (daycare, retirement homes)
The main cases of Shigella in the US are from S. ________ while in the developing world they are S. ________.
S. sonnei
S. flexneri
(T/F) Salmonella is a zoonotic pathogen.
True
What is the second most common cause of bacterial food-borne illness in the US?
Salmonella
_______ are a major source of Salmonella infection.
eggs
While it is possible to transmit Salmonella from dogs, cats, birds, horses, or livestock, it is commonly transmitted to humans via:
reptiles, chicks, ducklings
Which 3 diseases does Salmonella cause in humans?
- Gastroenteritis
- Typhoid Fever
- Paratyphoid Fever
Gastroenteritis caused by Salmonella is caused by (infection/intoxication).
infection (NO free-form toxin)
Salmonella Gastroenteritis only affects individuals with a specific:
MHC molecule
The largest bioterrorist attack in the US (Oregon, 1984) was caused by:
Salmonella (causing Gastroenteritis)
Typhoid Fever is caused by:
Salmonella enterica typhi
(T/F) Typhoid Fever ONLY infects humans.
True
(T/F) Typhoid Fever initially causes fever, malaise, and diarrhea.
FALSE (no diarrhea initially)
In NYC in 1906 and later in 1915, a major Typhoid Fever outbreak was caused by a cook named:
Typhoid Mary (Mary Mallon)
How is Typhoid Fever prevented?
live oral vaccine (but not 100% effective)
Paratyphoid Fever presents similarly to Typhoid Fever but with different Salmonella serotype and more (mild/severe) disease.
mild
Multi-drug resistance is a huge problem with which specific Salmonella serotype? Which species is it associated with?
DT104
cattle
(T/F) Animals are the source of Salmonella drug-resistance.
False
Salmonella _______ is recently emerging in Pakistan and resistant to 5 classes of antibiotics.
typhi
Which food & water pathogen causes sudden fever, malaise, nausea, jaundice, dark urine, and joint pain?
Hepatitis A Virus
How is Hepatitis A Virus transmitted?
fecal-oral (contaminated food/water)
List the 3 main sources of Hepatitis A transmission.
water, shellfish, salads
Where do Hepatitis A outbreaks usually occur?
crowded housing (prisons, military)
Recent outbreaks of Hepatitis A in the US include states ________ and ________.
California
Missouri
Children with Hepatitis A Virus often develop _________ disease.
subclinical
Which age group is most susceptible to fatality by Hepatitis A?
elderly
(T/F) Hepatitis A is a vaccine-preventable disease.
True
Signs of Hepatitis E Virus are similar to A but also have what other symptom?
clay-colored stool
Which group of people are especially susceptible to fatality by Hepatitis E Virus?
pregnant women
(T/F) Hepatitis E usually resolves without treatment.
True
An outbreak of Hepatitis E Virus in Singapore involved transmission via:
raw pig guts
Which food & water pathogen is highly contagious and causes Acute Gastroenteritis within 24-48 hours and is very common on cruise ships?
Norovirus
How is Norovirus transmitted?
fecal-oral
Which food and water pathogen is a common cause of worldwide, severe gastroenteritis in children? (Leading cause of severe diarrhea prior to US vaccine development)
Rotavirus
Most Rotavirus infections occur during:
winter
How is Rotavirus transmitted?
fecal-oral
Rotavirus vaccination caused a lower incidence of ________.
Type I Diabetes (virus accelerated Beta cells)
Which obligate intracellular protozoan parasite infects only felids as the definitive host and is the 3rd leading cause of food-borne illness death in the US?
Toxoplasma gondii
What kind of signs develop due to food-borne Toxoplasmosis?
flu-like symptoms
Toxoplasmosis in humans is transmitted by which 3 routes?
- foodborne
- zoonotic
- congenital
How is foodborne Toxoplasmosis transmitted?
ingest sporulated oocysts or tissue cysts
Which parasite of the GI tract causes short-term, mild watery diarrhea and is immediately infective upon excretion?
Cryptosporidium
Which two species of Cryptosporidium cause human disease?
C. parvum
C. hominis
Where did the Cryptosporidium outbreak occur in 1994 due to polluted public water supply (and inadequate chlorination)?
Milwaukee
What is the most frequent cause of non-bacterial/viral diarrhea in North America?
Giardia (Giardiasis)
Which 3 species of Giardia cause disease in humans?
G. duodenalis
G. lamblia
G. intestinalis
How is Giardia transmitted?
contaminated water (fecal-oral)
(T/F) Giardia cysts ARE NOT immediately infectious as they are passed in feces.
False
(T/F) Pets can commonly spread Giardia to humans and vice versa.
False (little risk - different species)
Etiology of Amoebic Dysentery.
Entamoeba histolytica
Amoebic Dysentery is more common in what locations?
tropics / subtropics
How is Entamoeba histolytica transmitted?
fecal-oral (cyst ingestion)
What is the major sign of Amoebic Dysentery?
bloody, mucousy diarrhea
Which two forms of diarrhea can occur with Amoebic Dysentery?
- gradual onset colitis
- severe acute (trophozoites present in stool)
What drug is used to treat Amoebic Dysentery?
Metronidazole (Flagyl)
How does Entamoeba histolytica cause disease and eventually death?
“nibbling” away of outer cell membrane
(T/F) Cyclosporiasis causes watery diarrhea and is endemic to tropical & subtropical countries.
Trie
Etiology of human-specific Cyclosporiasis.
Cyclospora cayetanensis
Cyclosporiasis is a fecal-orally transmitted disease linked to imported _______.
produce
(T/F) Cyclospora cysts in fresh feces are immediately infectious.
False
Which food-borne parasitic pathogen is nationally reportable?
Trichinellosis
The main etiology associated with Trichinellosis in humans is Trichinella ________, while other species are associated with wildlife.
T. spiralis
What type of animal meat is responsible for Trichinella spiralis transmission to humans?
pork (swine)
Which old fart discovered the life cycle of the Trichinella worm and determined that cooking killed the organism?
Rudolph Virchow
The most common source for Trichinellosis outbreaks is:
wild game
(T/F) Symptoms of Trichinellosis infection are very broad.
True
What is the only fungal food-borne disease discussed?
Aflatoxicosis
Aflatoxins are toxic compounds produced by _________ flavus & __________ parasiticus.
Aspergillus
_________ is a potent carcinogen produced by Aspergillus fungi.
Aflatoxin B1
The primary target for Aflatoxin B1 is:
liver
What are some food sources of Aflatoxin in the US?
corn, peanuts, cottonseed, milk, tree nuts
What Aflatoxicosis outbreak occurred in 2018?
PepsiCo peanuts
Aflatoxicosis causes cerebral edema and acute necrosis or carcinoma of the _________.
liver
