Chapter 20 Review Questions

Last update: 4/5/2010

1. What federal agency is responsible for investigating outbreaks of national importance?
2. The CDC recommends a 10-step approach for investigating outbreaks. List these steps and describe their importance. 
3. M/C: The x-axis of an epidemic curve represents: (a) the number of cases (b) a “time variable” (c) a “person variable” (d) a “place variable”
4. M/C: The y-axis of an epidemic curve represents: (a) the number of cases (b) a “time variable” (c) a “person variable” (d) a “place variable”
5. M/C: The statistical and epidemiologic term used to refer to an exception to the observed pattern of occurrence is a(n): (a) outlier (b) case (c) control (d) none of the above
6. How do outbreaks come to the attention of public health authorities?
7. What are epidemiologic surveillance systems?
8. Do epidemiologic surveillance systems contain complete information on occurrence?
9. Does increased number of cases reported to a surveillance system necessarily indicate an increase in occurrence?
10. How did a pharmacist contribute to the initial detection of HIV?
11. The decision whether or not to investigate an outbreak depends on many factors. List some of these factors and discuss their importance. 
12. List some of the goals of outbreak investigation.
13. Evans (1982) discusses 5 components of an outbreak investigation. The first is Define the Problem. Discuss what this means.
14. Evans discusses the descriptive epidemiology of an outbreak investigation. What is described in this phase of an investigation?
15. Hypotheses about outbreaks should address the source of the infection, the method of contamination and spread, and tests of possible _______________.
16. How do epidemiologists test their hypotheses? (See Table 20.1, item 4).
17. T/F? Reported outbreaks often represent sporadic occurrence of unrelated diseases.
18. After confirming reported cases, the number or rate of expected cases must be formally or informally compared to the ___________ rate or number of cases to confirm the occurrence of “epidemic levels.”
19. Increases in occurrence can be due to random fluctuations or systematic fluctuations due to an artifact or bias in reporting. What type of information biases may result in increases in the reported number of cases?
20. How can an increase in population size cause an increase in the number of cases?
21. How might diagnostic suspicion result in an artifactual increase in the number of cases reported to a health agency?
22. What is a “case definition”?
23. What type of information is collected during an outbreak investigation? (p. 356)
24. List the objectives of descriptive epidemiology. (p. 356)
25. T/F: John Snow recognized that the cholera epidemic associated with the Broad Street pump might have burned itself out before the pump handle was removed.
26. Define “incubation period.”
27. List factors that determine the length of an incubation period.
28. What is a hypothesis?
29. Hypothesis development requires an understanding of the _______ ________ and population at risk
30. To whom do you report the findings of an outbreak?
31. When communicating findings, always consider the “who, what, where, when, ___________, and ______________.”

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