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EPID 410: Homework 2

25 points – Due Thursday, October 4 at 11:59 PM on Blackboard

Choose the BEST answer for each question:

1. Which of the statements is true for “Incubation period”? (2 points)


a. Interval from receipt of infection to the time of onset of illness
b. Reflects the time needed for the organism to replicate sufficiently for clinical disease to result
c. No clinical symptom is shown
d. All of the above

2. Identify which of the following letters represent ‘epidemic’ and ‘endemic’ on the following figure? (4
points)

B
No. of cases of a disease

Time

A: __endemic__________

B: __epidemic_________

3. Read the paragraph below about Dengue Fever and answer the following questions:

Dengue is an acute infectious disease with clinical symptoms of high fever, severe headache, backache, joint
pains, nausea and vomiting, eye pain, and rash. It is caused by any one of four closely related flavi-viruses
and transmitted to people by the bite of an Aedes mosquito that is infected with a dengue virus. The mosquito
becomes infected with dengue virus when it bites a person who has dengue and after about a week can transmit
the virus while biting a healthy person. Monkeys may serve as a reservoir in some parts of world. Residents
of or visitors to tropical urban areas and other areas where dengue is endemic are at highest risk of becoming
infected. While a person who survives an attack of dengue caused by one serotype develops lifelong immunity
to that serotype, there is no cross-protection against the three other serotypes.
EPID 410: Homework 2
25 points – Due Thursday, October 4 at 11:59 PM on Blackboard

i) Please complete the epidemiologic triad of Dengue Fever. (6 points)

Host: People, those most at risk


are those living in/visiting tropical
urban areas where dengue is
prevalent

Agent: flavi-viruses carried by the Environment: tropical urban


Aedes mosquito areas, Monkeys can be reservoirs
in some parts of the world

ii) What type of transmission is this? Be very specific and justify your answer. (3 points)
Indirect transmission through use of a vector. The vector with this disease is the Aedes mosquito, which carries
the virus and infects humans through a bite. Since the mosquitos are those who infect, they are the vector with
this disease. Since the disease transmits through use of a vector, the transmission is indirect.

4. Differentiate between active and passive immunity. (4 points)


Active immunity is a long duration and is a direct response to unknown pathogens using the body’s own
antibodies. It can be natural, through having a disease, or artificial, through a vaccine. Passive immunity is short
duration and uses antibodies received from outside the body. Passive immunity can also be natural, through
breast-feeding, or artificial, such as through a shot of immunoglobulins.

5. An outbreak of gastritis occurred following a New Year’s Eve dinner. The data in the following table were
obtained shortly after the outbreak, from a questionnaire completed by everyone attended that dinner.

Contact with foods No Contact with food


Foods Attack rate
consumed Attack Attack difference
Ill Well Total Ill Well Total
rate rate
Steak 30 45 75 40.00% 40 160 200 20.00% 20.00%

Fish 60 40 100 60.00% 15 135 150 10.00% 50.00%

Salad 25 50 75 33.33% 25 150 175 14.29% 19.04%

Beverages 50 150 200 25.00% 5 35 40 12.50% 12.50%

i) Calculate the attack rates and attack rate differences in the table above. (6 points)

ii) If you compare the attack rate of people who consumed each type of food with attack rates among
people who did not eat that particular food, which food was most likely responsible for the outbreak?
(2 points) The Fish is most likely to have caused the outbreak in this scenario.