Exam 2 Flashcards
(T/F) The majority of outbreaks in laboratory settings are related to known accidents.
False!
Accidents are less likely to be the cause of lab facility outbreaks, whereas over 80% of cases are related to:
infectious aerosols
Many lab facility outbreaks occur at ________, which take a major economic loss if this occurs, therefore biosafety measures are extensive.
universities
What is the goal of biosafety?
prevent infections (inside & outside lab)
(T/F) Biosafety levels 1-4 are from lowest hazard to increased hazard.
True
(T/F) Biosecurity Level 1 agents cause disease in humans but with quick recovery or treatment available.
False (unknown to cause disease in healthy humans)L
List the 3 main examples of pathogens present in a Biosecurity Level 1 facillity.
- Bacillus subtilis
- Saccharomyces cerevisiae
- E. coli (avirulent strains)
(T/F) PPE is necessary in all levels of biosecurity.
False (not required in Level 1 & 2)
Biosecurity Level 2 indicates moderate hazards, where _______ and _______ are available.
vaccination
antibiotics
List 5 examples of Biosecurity Level 2 pathogens.
- Measles
- Salmonella enterica
- Staph
- Toxoplasma
- Hepatitis B
_________ are not required in Level 2 facilities unless the lab produces highly concentrated or aerosolized pathogens.
biosafety cabinets
What equipment is plexiglass with a vent that pulls air in via negative pressure to present contaminated aerosol spread in the lab?
biosafety cabinets
(T/F) Autoclaves are not required in each Level 2 facility.
True (but require nearby access)
Level 3 facilities deal with serious or potentially lethal diseases spread via:
inhalation
(T/F) Level 3 facilities deal with serious and potentially lethal diseases which are not treatable or preventable.
False (serious/lethal but ARE treatable or preventable)
Level (2/3) is more common than (2/3).
2, 3
What is the “hallmark” of a Level 3 facility?
redundancy (ALWAYS having back-ups –> gloves, autoclaves, etc)
List 4 potential pathogens in Level 3 biosafety facilities.
- Mycobacterium tuberculosis
- St. Louis Encephalitis Virus
- Coxiella burnetii
- Bacillus anthracis
For Level 3 biosafety labs, there are a few additional facility requirements. List 4 of them.
- separate isolation zone (away from traffic)
- double-door entry
- directional inward airflow
- single-pass air (NO recirculation!)
Room penetrations such as plugs need to be sealed in a Level ___ biosafety lab.
3
Which biosafety level requires use of PPE? What does PPE stand for?
Level 3
Personal Protective Equipment
BSL-3 Ag is a type of Level 3 biosafety that has a special concern for pathogen exposure to:
agriculture
(T/F) All Level 3 biosafety facilities have hyperfiltered air prior to entrance.
False (ONLY BSL-3Ag)
What special facility difference is present in BSL-3 Ag that is not used in regular BSL 3?
floor drains (collect liquid from animals in tanks which will be autoclaved)
What method is used for carcass disposal in BSL-3 Ag?
tissue digestor (liquefies & sterilizes tissues)
Biosecurity Level 4 includes serious and lethal diseases (with/without) available prevention and treatment.
without
All pathogens in Biosafety Level 4 facilities are:
viruses
The new method for BSL 4 uses conventional biosafety cabinets and _______ suits.
space (higher protection than PPE)
What must workers in BSL 4 do prior to exiting the lab?
chemical shower followed by conventional shower
List 3 examples of agents in a BSL 4 facility.
- Ebola virus
- Herpes B virus
- Lassa fever virus
List 4 major routes of infection that occur in lab settings.
- parenteral (needles)
- spills (skin, mucous membranes)
- ingestion / eyes
- aerosols
The Antiterrorism & Effective Death Penalty Act in 1996 initially came about after concern when a member of the Aryan Nations acquired __________ from American Type Culture Collection by mail border.
Yersinia pestis (plague)
The Antiterrorism & Effective Death Penalty Act in 1996 lists agents with severe risk to public health & safety as well as procedures for:
transfer of agents
Select agents and toxins listed in the Antiterrorism & Effective Death Penalty Act are listed as possible bioterrorism potential. They require inspection by _______ or ______ and facilities of BSL ____ or ____.
CDC or USDA
BSL 3 or 4
3 corporations are responsible for determining select agents and toxins as possible bioterrorism threats. What are they? And what kind of pathogens are they concerned with?
- Health & Human Services (human pathogens)
- USDA (zoonotic)
- Overlap (human to animal OR animal to human)
List the 5 biggest human pathogen bioterrorism threats listed by the Health & Human Services.
- botulism toxins
- Coxiella burnetii
- Yersinia pestis
- Francisella tularensis
- Ebola virus
The select bioterrorism threats listed by the Health & Human Services are inspected by _______.
CDC
The USDA lists zoonotic select bioterrorism potential agents such as _______________.
Foot & Mouth Disease Virus
The USDA lists zoonotic bioterrorism select agents such as Foot and Mouth Disease virus and is inspected by __________.
USDA only
The select bioterrorism agents that include overlap, meaning can spread from humans to animals or animals to humans, include which two agents? And what corporation inspects them?
Bacillus anthracis
Burkholderia mallei
CDC
What broad, but still active Act was passed regarding restrictions on obtaining and shipping of select bioterrorism agents after 9/11?
USA Partiot Act (2001)
List 5 categories of people who are restricted from accessing select agents with bioterrorism potential.
- individuals indicted (crime > 1 year prison)
- fugitive
- illegal alien
- mental institution stay
- dishonorable armed service discharge
List the 2 possible penalties for violating select agent use and restrictions.
- civil money (fine)
- criminal (prison)
Those that violate select agent use and restrictions can be fined up to $___________ and in prison for up to ________.
250,000
5 years
What is the “driving force” for Biosecurity Levels?
emerging disease threats
__________ has the purpose to keep agents WITHIN a facility while _________ has the purpose to keep pathogens from entering the facility in the first place.
biocontainment
biosecurity
Biosecurity is mostly related to which type of animals? Why?
food animals (reduce costs & protect food supply)
What are the 3 main biosecurity principles?
- isolation / quarantine
- resistance
- santiation
Which biosecurity principle involves the following:
“keep animals healthy by good nutrition, environmental, and other practices so they are less likely to become infected”
resistance
List the 5 possible routes of transmission which determine biosecurity measures.
- direct contact
- fomites
- aerosols
- ingestion
- vectors
List the 3 steps of cleaning & disinfection for biosecurity practices.
- remove organic matter
- wash & rinse
- disinfection
(T/F) Using a concentration greater than labelled for disinfectants can increase its efficacy.
False (can be LESS effective)
In terms of vector control regarding biosecurity practices, ________ ________ prevents egg laying of arthropod vectors, such as minimizing long vegegation.
source reduction
Bacillus anthracis is a (aerobic/anerobic) _______-forming bacteria.
aerobic
endospore
List the 2 toxins used by Bacillus anthracis.
- lethal toxin
- edema toxin
Bacillus anthracis uses lethal toxin which is composed of ___________ + __________.
lethal factors + protective antigen
What allows for Bacillus anthracis to bind to cell receptors?
protective antigen
Edema toxin of Bacillus anthracis is composed of ___________ + __________.
edema factor + protective antigen
Both lethal and edema toxins for Bacillus anthracis are encoded on _______ plasmid.
pXO1
The capsule for Bacillus anthracis is encoded on ______ plasmid and has what function?
pXO2
anti-phagocytic
How is Bacillus anthracis transmitted?
ingestion of spores (soil/water)
Once Bacillus anthracis spores are ingested, how do they enter the tissues?
enter abrasion in GI tract
Bacillus anthracis replicates in ________ cells and goes to the lymph nodes before bacteremia and toxemia.
phagocytic
(T/F) Outbreaks of anthrax often occurs at the human level.
False (see cases but see animal outbreaks)
List the 4 disease forms of Anthrax.
- cutaneous anthrax
- gastrointestinal anthrax
- pulmonary anthrax
- injection anthrax
95% of Anthrax cases are what form?
Cutaneous Anthrax
In Cutaneous Anthrax, spores enter via:
abrasion/break in skin
(T/F) Cutaneous Anthrax often leads to bacteremia/toxemia and later death.
False (slow-developing, NOT usually leading to these)
Cutaneous Anthrax often causes a painful, malignant pustule lesion with a necrotic center called:
black eschar
(T/F) The black eschar caused by Cutaneous Anthrax is treatable.
True
Which form of Anthrax is RARE in the US?
Gastrointestinal
How is GI anthrax transmitted?
ingested meat
The form of Anthrax also known as “Woolsorter’s Disease” is:
Pulmonary Anthrax
Which form of Anthrax is a form of concern for biological weapons?
pulmonary anthrax
How is Pulmonary Anthrax transmitted?
inhalation of spores
What unique sign is seen in Pulmonary Anthrax?
bi-phasic (initial flu illness followed by acute phase of respiratory distress + toxemia)
Pulmonary Anthrax leads to respiratory distress and death within:
24 hours
What is injection anthrax related to?
heroin injection / addiction
Where did injection anthrax outbreak in 2009-2013?
germany, scotland, england
(T/F) Anthrax is a potential bioterrorism agent due to ability for secondary spread from human-to-human.
FALSE (NOT secondarily spread between people)
What is the best way to prevent Anthrax?
vaccination
In veterinary medicine, _______ _______ is a live spore vaccine which makes toxin but has no _________ for virulence.
Sterne Strain
capsule
Anthrax Vaccine Adsorbed (AVA) and British Anthrax Vaccine Precipitated (AVP) are both ________ vaccines.
human
(T/F) While the anthrax vaccine is effective, there are long-term effects associated.
False
(T/F) Systemic effects can occur due to Anthrax vaccination.
True (5-35%)
Anthrax vaccine requires ____ IM injections and an annual booster.
5
Plague is caused by:
Yersinia pestis
Yersinia pestis is a gram (positive/negative) _______-shaped bacteria.
negative
rod
What unique look does Yersinia pestis have when stained?
“safety pin”
How is Plague transmitted?
flea bite (or direct flea contact)
The most common flea in the US associated with Yersinia pestis transmission is:
Oropsylla montanus (California ground squirrel flea, Rock Squirrel flea)
How does a flea transmit plague?
bloodmeal from infected animal –> regurg into new host on next bloodmeal
The plague can be transmitted via _______ or _______ cycle.
sylvatic
urban
The plague sylvatic cycle is via which animal? Urban cycle?
Sylvatic: wild rodent
Urban: rat
List 2 reservoirs for plague.
deer mice
ground squirrels
(T/F) Cats are highly susceptible to plague, developing the same disease as humans.
True
(T/F) Cats cannot transmit plague to humans.
False (can)
(T/F) Although cats can transmit plague to humans, they are POOR vectors of it.
True
75% of Feline Bubonic Plague manifests as:
submandibular lymphadenitis
After fever, lethargy, and anorexia in cats affected with Feline Bubonic Plague, they develop what two signs prior to death?
DIC
multi-organ failure
Dogs are generally (sensitive/resistant) to plague infection.
resistant
Dogs that do develop plague develop:
general lymphadenopathy
List the 3 clinical syndromes of Plague.
- bubonic
- pneumonic
- septicemic
80% of US cases are ________ plague.
bubonic
What is the mortality rate for Bubonic Plague?
50%
What is the primary sign seen in Bubonic plague?
lymphadenopathy
In addition to lymphadenopathy, ________ can be seen in Bubonic plague infection, indicated by a swelling at the inoculation site.
buboes
Bubonic plague can lead to secondary ________ plague.
pneumonic
________ plague is almost always fatal if not treated within 24 hours from sign onset.
Pneumonic
Pneumonic Plague leads to what syndrome characterized by shock and refractory pulmonary edema?
Adult Respiratory Disease Syndrome
_________ plague is a complication of the other two forms.
septicemic
(T/F) Septicemic Plague is fatal without treatment.
True
Septicemic Plague leads to ______, hypotension/shock, and death.
DIC
(T/F) Plague is ENDEMIC to the US.
True
Where are most cases of plague in the US?
southwest (AZ, CO, NM, UT)
Plague is found worldwide except which 2 continents?
Australia
Antarctica
Most cases of plague (95%) worldwide occur in:
Sub-Saharan Africa + Madagascar
What disease is also known as “Rabbit Fever”?
Tularemia
Etiology of Tularemia.
Francisella tularensis
Francisella tularensis is a gram (positive/negative) __________.
negative
coccobacillus
Francisella tularensis can persist for 3-4 months in what substances? What can it persist in for >3 years?
3-4 months: mud, water, dead animals
>3 years: frozen meat
Francisella tularensis is (resistant/sensitive) to disinfectants and heat.
sensitive
F. tularensis biovar ________ or MORE virulent than biovar _________.
tularensis (Type A)
holarctica (Type B)
Match the F. tularensis biovar to its location:
- Eurasia and North America
- only North America
- F. tularensis holarctica
- F. tularensis tularensis
Match which F. tularensis biovar goes with each reservoirs:
- rabbits, squirrels, ticks
- muskrats, voles, mice rats
- tularensis (Type A)
- holarctica (Type B)
List the 4 modes of F. tularensis transmission.
- direct contact (rabbits/mammals)
- ingestion (undercooked meat, water)
- vector-borne (arthropods)
- aerosols (dust)
(T/F) F. tularensis can be transmitted from person to person.
False (unless pneumonic form)
Which vectors can transmit F. tularensis?
Ticks (transovarial)
Mosquitos/flies (infrequent in Europe)
What species serve as reservoirs for F. tularensis.
MANY mammals (rabbits, beaver, muskrats)
ticks
some birds
F. tularensis requires a (small/large) infectious dose for inoculation and inhalation and a (small/large) infectious dose for oral transmission.
small
large
_________ transfer of F. tularensis is possible, seen in a case in 2017 with positive rabbits near a patient’s household.
transplantation
Where did cottontail rabbits cause the first human case of F. tularensis and later clusters of pneumonic cases related to mowing from 1930-2003?
Martha’s Vineyard
List a few initial signs of F. tularensis infection in humans.
sudden fever
chills
headache
myalgia
6 clinical syndromes can occur due to F. tularensis infection. List them.
- ulceroglandular
- glandular
- oculoglandular
- oropharyngeal
- typhoidal
- pulmonary
Which clinical syndrome of F. tularensis is most common?
ulceroglandular
The Ulceroglandular form of F. tularensis uses ulcers as an entry site and causes ____________ in humans.
regional lymphadenopathy
(T/F) The Glandular form of F. tularensis causes ulceration and regional lymphadenopathy.
False (NO ulceration)
List 2 manifestations of Oculoglandular Syndrome of F. tularensis.
- conjunctivitis
- regional lymphadenopathy
Which F. tularensis syndrome is the SECOND most common?
glandular
Oropharyngeal Form of F. tularensis is transmitted via:
ingestion