Emerging and Re-emerging Infections Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Emerging and Re-emerging Infections. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Emerging and Re-emerging Infections Indian Medical PG Question 1: Zoonotic diseases are -
- A. Anthrax
- B. Plague
- C. Salmonellosis
- D. All of the options (Correct Answer)
Emerging and Re-emerging Infections Explanation: ***All of the options***
- **Anthrax**, **Plague**, and **Salmonellosis** are all well-established examples of zoonotic diseases, which are infections naturally transmitted between vertebrate animals and humans.
- These diseases represent a diverse spectrum of bacterial infections with significant public health implications worldwide.
**Anthrax**
- Caused by *Bacillus anthracis*, a spore-forming bacterium naturally found in soil that primarily affects livestock and wild herbivores.
- Humans acquire infection through contact with infected animals or contaminated animal products (hides, wool, meat).
- Clinical forms include cutaneous (most common), inhalational (most severe), and gastrointestinal anthrax.
- Remains an important occupational hazard for veterinarians, farmers, and those handling animal products.
**Plague**
- Caused by *Yersinia pestis*, maintained in nature through rodent-flea cycles.
- Transmission to humans occurs primarily via bites from infected fleas or direct contact with infected animals.
- Historically responsible for devastating pandemics including the Black Death.
- Clinical manifestations include bubonic (most common), pneumonic (person-to-person transmission possible), and septicemic plague.
**Salmonellosis**
- Caused by non-typhoidal *Salmonella* species, commonly colonizing the intestines of various animals including poultry, cattle, reptiles, and pets.
- Humans typically acquire infection through consumption of contaminated food (undercooked meat, eggs, unpasteurized dairy) or direct animal contact.
- Presents as acute gastroenteritis with diarrhea, fever, and abdominal cramps.
- One of the most common foodborne zoonotic infections globally.
Emerging and Re-emerging Infections Indian Medical PG Question 2: A man with chills, fever, and headache is thought to have "atypical" pneumonia. History reveals that he raises chickens, and that approximately 2 weeks ago he lost a large number of them to an undiagnosed disease. Which of the following is the most likely diagnosis of this man's condition?
- A. Leptospirosis
- B. Relapsing fever
- C. Anthrax
- D. Ornithosis (Correct Answer)
Emerging and Re-emerging Infections Explanation: ***Ornithosis***
- The patient's symptoms of **chills, fever, headache, and atypical pneumonia**, combined with a history of **raising chickens** that recently died from an undiagnosed disease, are highly suggestive of ornithosis (also known as **psittacosis** or **parrot fever**). [2], [3]
- This zoonotic infection is caused by **Chlamydophila psittaci** and is transmitted to humans through inhalation of contaminated aerosols from infected birds (poultry, parrots, pigeons). [2]
*Leptospirosis*
- **Leptospirosis** is typically associated with exposure to **contaminated water or soil** with animal urine, not direct contact with sick poultry.
- While it can cause fever and headache, it often presents with **jaundice, renal failure, and hemorrhagic manifestations**, which are not mentioned here.
*Relapsing fever*
- **Relapsing fever** is characterized by **recurrent episodes of fever** separated by afebrile periods, caused by **Borrelia** species transmitted by lice or ticks.
- The clinical presentation does not align with the typical course or epidemiological link to sick chickens.
*Anthrax*
- **Inhalational anthrax** can cause severe respiratory symptoms and fever but is primarily associated with exposure to **Bacillus anthracis spores**, often from infected livestock (cattle, sheep) or bioweapon exposure. [1]
- The rapid death of a large number of chickens and the patient's "atypical pneumonia" do not fit the typical presentation or common transmission routes of anthrax. [1]
Emerging and Re-emerging Infections Indian Medical PG Question 3: What is the first step an epidemiologist takes in an epidemic investigation?
- A. Confirm the diagnosis (Correct Answer)
- B. Identify the prone people
- C. Identify the causative factors
- D. Identify the cases
Emerging and Re-emerging Infections Explanation: ***Confirm the diagnosis***
- The initial and most crucial step is to **confirm the diagnosis** of the disease in question to ensure that the reported cases are indeed suffering from the same condition.
- This step helps to avoid misclassification and ensures the investigation focuses on a specific, confirmed health problem.
*Identify the cases*
- While essential, **identifying cases** usually follows initial diagnostic confirmation, as you need a clear case definition based on a confirmed diagnosis to correctly identify who is a case.
- This involves defining who is considered a case based on symptoms, laboratory results, and epidemiological links.
*Identify the prone people*
- **Identifying prone people** refers to determining the population at risk, which is a subsequent step after understanding the confirmed disease and its initial pattern.
- This step typically falls under characterizing the distribution of the disease (person, place, time) in the investigation.
*Identify the causative factors*
- **Identifying causative factors** is a later stage in the investigation, often involving analytical studies to test hypotheses, which can only occur effectively once the diagnosis is confirmed and cases are clearly defined and counted.
- This step aims to understand *why* the epidemic is occurring, after establishing *what* is occurring.
Emerging and Re-emerging Infections Indian Medical PG Question 4: Which diseases are infectious but not communicable?
- A. Tetanus (Correct Answer)
- B. Mumps
- C. Scarlet fever
- D. Measles
Emerging and Re-emerging Infections Explanation: **Key Concept:** Infectious diseases are caused by microorganisms, while communicable diseases can spread from person to person. Some diseases are infectious but NOT communicable.
***Correct: Tetanus***
- Tetanus is caused by toxins produced by *Clostridium tetani*, which typically enters the body through **wounds contaminated with soil or feces**
- It is **infectious** because a microorganism causes the disease
- It is **NOT communicable** as it **cannot be spread directly from person to person** - the bacteria must enter through environmental contamination
- Classic example of infectious but non-communicable disease
*Incorrect: Mumps*
- Mumps is a **communicable disease** caused by the mumps virus, primarily spread through **respiratory droplets** from person to person
- Leads to inflammation of **salivary glands**, especially the parotid glands
- Both infectious AND communicable
*Incorrect: Scarlet fever*
- Scarlet fever is a **communicable bacterial infection** caused by group A *Streptococcus*, spread through **respiratory droplets** from person to person
- Presents with a characteristic **red rash**, sore throat, and fever
- Both infectious AND communicable
*Incorrect: Measles*
- Measles is a **highly communicable viral disease** transmitted through **airborne droplets** from person to person
- Characterized by a distinctive **rash, fever, cough, coryza, and conjunctivitis**
- Both infectious AND communicable
Emerging and Re-emerging Infections Indian Medical PG Question 5: All of the following conditions are immediate priorities in the WHO's "Vision -2020: The Right to sight" except:
- A. Cataract
- B. Epidemic conjunctivitis (Correct Answer)
- C. Onchocerciasis
- D. Trachoma
Emerging and Re-emerging Infections Explanation: ***Epidemic conjunctivitis***
- While **epidemic conjunctivitis** can cause significant discomfort and temporary vision impairment, it is generally **self-limiting** and rarely leads to permanent blindness.
- It was not identified as one of the top five global causes of avoidable blindness targeted by the Vision 2020 initiative.
*Cataract*
- **Cataract** is the **leading cause of blindness** globally, accounting for approximately half of all cases.
- It is a highly treatable condition through surgery, making it a critical priority for Vision 2020.
*Onchocerciasis*
- Also known as **river blindness**, onchocerciasis is a parasitic disease that causes severe visual impairment and blindness.
- It is a significant public health problem in several regions, particularly in Africa, and was a key focus of Vision 2020 due to its widespread impact and the availability of preventive chemotherapy.
*Trachoma*
- **Trachoma** is the **leading infectious cause of blindness** worldwide, caused by *Chlamydia trachomatis*.
- Given its preventable and treatable nature, and its prevalence in many impoverished areas, it was designated as one of the priority diseases under Vision 2020.
Emerging and Re-emerging Infections Indian Medical PG Question 6: Which of the following is the true statement regarding measures to prevent typhoid transmission in the community?
- A. Typhoid vaccine administration is the best method of preventing transmission.
- B. Person-to-person transmission is the primary mode of spread.
- C. Drug resistance in typhoid is not as big a problem as in TB.
- D. Hygiene practice and clean sanitation control are more important than the typhoid vaccine. (Correct Answer)
Emerging and Re-emerging Infections Explanation: ***Hygiene practice and clean sanitation control is more important than the typhoid vaccine.***
- **Improved sanitation**, safe water supplies, and adequate hygiene practices are fundamental in controlling the spread of **typhoid fever**, as the disease is primarily transmitted through the **oral-fecal route**.
- While vaccines are an important tool, they offer only partial protection and must be combined with **robust public health infrastructure** and **sanitation measures** for effective prevention.
*Typhoid vaccine administration is the best method of preventing transmission.*
- Typhoid vaccines offer protection, but their effectiveness is not 100%, and they typically require **booster doses**
- **Vaccination campaigns** are most effective when implemented alongside improvements in **water and sanitation infrastructure**, as vaccines alone cannot fully prevent transmission in areas with poor hygiene.
*Person-to-person transmission is the primary mode of spread.*
- While person-to-person transmission can occur, especially in settings with poor hygiene, the primary mode of spread for typhoid is through the **ingestion of food or water contaminated** with the feces of an infected person or carrier.
- This emphasizes the crucial role of **water and food safety** rather than just focusing on direct person-to-person contact.
*Drug resistance in typhoid is not as big a problem as in TB.*
- **Antimicrobial resistance (AMR)** in typhoid fever, particularly to fluoroquinolones and extended-spectrum beta-lactamase (ESBL) producing strains, is a **significant and growing global health concern**, complicating treatment.
- While TB also faces serious drug resistance issues, the escalating problem of **extensively drug-resistant (XDR)** and **multi-drug resistant (MDR)** typhoid strains makes it a substantial threat, impacting treatment options and increasing morbidity and mortality.
Emerging and Re-emerging Infections Indian Medical PG Question 7: The Roll Back Malaria programme focused mainly on
- A. IEC campaigns for community awareness
- B. Insecticide treated bed nets (Correct Answer)
- C. Development of larvivorous fishes for eradication of larvae.
- D. Presumptive treatment of malaria case
Emerging and Re-emerging Infections Explanation: ***Insecticide treated bed nets***
- The **Roll Back Malaria (RBM)** program, launched in 1998, focused significantly on key interventions including the promotion and distribution of **insecticide-treated nets (ITNs)**.
- ITNs are highly effective in **preventing mosquito bites**, thus reducing malaria transmission, especially in vulnerable populations.
*IEC campaigns for community awareness*
- While **Information, Education, and Communication (IEC)** campaigns are crucial for health programs, they were a supportive component rather than the primary focus of RBM's core intervention strategy.
- RBM emphasized **tangible interventions** with direct impact on disease transmission.
*Development of larvivorous fishes for eradication of larvae*
- The use of **larvivorous fish** is a form of biological control, which is typically part of **integrated vector management** but not the central pillar of RBM's strategy.
- RBM prioritized interventions with **broad, immediate impact** across larger populations.
*Presumptive treatment of malaria case*
- **Presumptive treatment** (treating based on symptoms without laboratory confirmation) was an important aspect of early malaria control but not the main strategic thrust of the RBM initiative.
- RBM's primary focus was on **prevention and rapid diagnosis/treatment** using effective antimalarials, and vector control strategies.
Emerging and Re-emerging Infections Indian Medical PG Question 8: Which of the following diseases is not under surveillance in the Integrated Disease Surveillance Project (P-Form)?
- A. Snake bite (Correct Answer)
- B. Acute respiratory tract infections
- C. Tuberculosis
- D. Leptospirosis
Emerging and Re-emerging Infections Explanation: ***Snake bite***
- While a public health concern, **snake bites** are generally not included in the list of diseases under routine surveillance by the Integrated Disease Surveillance Project (IDSP) P-Form, which focuses on infectious diseases with epidemic potential.
- The IDSP primarily monitors for **communicable diseases**, outbreaks, and other public health threats requiring rapid detection and response.
*Acute respiratory tract infections*
- **Acute respiratory tract infections (ARIs)**, including severe acute respiratory infections (SARIs), are a major focus of IDSP surveillance due to their high transmissibility and potential for large-scale outbreaks.
- Surveillance helps in detecting trends, identifying new pathogens, and implementing timely control measures.
*Tuberculosis*
- **Tuberculosis (TB)** is a priority disease for surveillance under the IDSP due to its high prevalence, chronic nature, and the need for continuous monitoring of incidence, prevalence, and treatment outcomes.
- The IDSP plays a role in tracking TB cases and drug resistance patterns to inform national control programs.
*Leptospirosis*
- **Leptospirosis** is an emerging infectious disease with epidemic potential, especially in areas with poor sanitation and during floods, making it a crucial disease for IDSP surveillance.
- Surveillance helps in early detection of outbreaks and implementation of control measures to prevent spread.
Emerging and Re-emerging Infections Indian Medical PG Question 9: Which disease was removed from active WHO surveillance requirements following its global eradication?
- A. Guinea worm
- B. Typhoid
- C. HIV/AIDS
- D. Smallpox (Correct Answer)
Emerging and Re-emerging Infections Explanation: ***Smallpox***
- Smallpox was **globally eradicated** in 1980 through a concerted vaccination effort, making it the first human disease eradicated.
- Due to its eradication, it has been **removed from active WHO surveillance requirements** as it no longer poses a threat to public health.
*Guinea worm*
- While significant progress has been made in Guinea worm eradication, it has **not yet been fully eradicated**, with a few endemic areas remaining.
- It is currently still subject to **active surveillance efforts** by the WHO to monitor progress towards elimination.
*Typhoid*
- Typhoid is caused by *Salmonella Typhi* and remains a significant public health issue, especially in areas with poor sanitation.
- It is a **notifiable disease** and continuously monitored by the WHO and national health agencies, especially with concerns about **antimicrobial resistance**.
*HIV/AIDS*
- HIV/AIDS is a **global pandemic** with ongoing high prevalence and incidence rates worldwide, particularly in certain regions.
- It is under **intensive surveillance and control programs** by the WHO, given its significant global health burden and lack of a definitive cure or vaccine for complete eradication.
Emerging and Re-emerging Infections Indian Medical PG Question 10: Emergency or re-emergence seen in which of the following organisms?
a) Polio virus
b) Measles virus
c) Nipah virus
d) West Nile virus
e) Ebola virus
- A. abd
- B. Hepatitis B virus
- C. bde
- D. cde (Correct Answer)
Emerging and Re-emerging Infections Explanation: ***cde***
- **Nipah virus** is a well-known **emerging infectious disease** due to spillover from animal reservoirs.
- **West Nile virus** is considered a **re-emerging pathogen** that has spread globally, causing outbreaks.
- **Ebola virus** is famously associated with several **re-emergence events** in Africa, characterized by high fatality rates.
*abd*
- **Polio virus** is targeted for eradication and, while still circulating in some regions, is not typically classified as an emerging or re-emerging disease in the same context as the others.
- **Measles virus** is a vaccine-preventable disease that can cause outbreaks due to waning immunity or unvaccinated populations, but its pattern is more of a persistent public health challenge rather than true emergence/re-emergence.
*Hepatitis B virus*
- **Hepatitis B virus** is a chronic global health burden but is not considered an emerging or re-emerging virus; it has been endemic for many decades.
- Its transmission patterns and epidemiological profile are well-established.
*bde*
- **Measles virus**, as mentioned, is not typically categorized as an emerging or re-emerging infectious disease.
- The combination here incorrectly groups measles with true emerging/re-emerging pathogens.
*ade*
- **Polio virus** is primarily a target for eradication, not an emerging or re-emerging pathogen.
- This option incorrectly includes polio within the category of emerging/re-emerging diseases.
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