MICI 1100 Final Exam

1. What is Antigenic shift/drift? One way influenza viruses change is called

“antigenic drift.

2. What does latency mean? the state or period of living or developing in a host without

producing symptoms the cellular mechanisms by which viral latency is maintained or

viral replication is induced is not known.

3. Examples of microbes that can become latent.? herpes simplex virus

(oral and genital herpes), varicella-zoster virus (chickenpox and shingles), and Epstein-

Barr virus (mononucleosis).

4. How is measles transmitted? it can spread to others through

coughing and sneezing. If other people breathe the contaminated air or
touch the infected surface, then touch their eyes, noses, or mouths, they
can become infected. Animals do not get or spread measles. The virus
can live for up to two hours in an airspace. What are the symptoms? The initial
symptoms of measles can include:
 a runny or blocked nose.
 sneezing.
 watery eyes.
 swollen eyelids.
 sore, red eyes that may be sensitive to light.
 a high temperature (fever), which may reach around 40C (104F)
 small greyish-white spots in the mouth.
 aches and pains.
What are complications? More common complications of measles include:
 diarrhoea and vomiting, which can lead to dehydration.
 middle ear infection (otitis media), which can cause earache.
 eye infection (conjunctivitis)
 inflammation of the voice box (laryngitis)
 infections of the airways and lungs (such as pneumonia, bronchitis and croup)
5. How is Varicella transmitted? The virus can be spread from person to person
by direct contact, inhalation of aerosols from vesicular fluid of skin lesions of acute
 varicella or zoster, and possibly through infected respiratory secretions that also may be

aerosolized.

What are the symptoms? Symptoms include fever, aches, tiredness,

headache, loss of appetite, as well as red spots on the face, scalp, torso,

arms and legs. These spots are very itchy and will look like blisters filled with

clear fluid.

What are complications? Bacterial infections of the skin and soft tissues

in children, including Group A streptococcal infections. Infection of the lungs

(pneumonia) Infection or swelling of the brain (encephalitis, cerebellar ataxia)

6. How is rotavirus transmitted? Rotavirus is transmitted by fecal-oral contact

and possibly by contaminated surfaces and hands and respiratory spread. Other
gastrointestinal pathogens are also transmitted primarily by the fecal oral route, although
contaminated surfaces, hands or food may also serve to transmit infection in some
cases. What are the symptoms? The most common symptoms of rotavirus are severe
watery diarrhea, vomiting, fever, and/or abdominal pain. Symptoms usually start
about two days after a person is exposed to rotavirus. Vomiting and watery diarrhea can
last three to eight days. What are complications? Rotavirus Complications

 Severe diarrhea.
 Dehydration.
 Electrolyte imbalance.
 Metabolic acidosis.
 Children who are immunocompromised may have more severe or persistent
disease.
7. How is Listeria transmitted? Listeria can be spread to people by several different
methods. Eating food contaminated with the bacteria, such as through raw
(unpasteurized) milk or contaminated vegetables, is often a source for cases. The
bacteria may be passed from mother to fetus during pregnancy or directly to the newborn
at the time of birth. What are the symptoms? Symptoms of listeriosis vary depending on
the form and can come on suddenly. Symptoms may include fever, muscle aches,
severe headache, nausea, vomiting, diarrhea, stiff neck, confusion, loss of
balance, and convulsions. What are complications? Most listeria infections are so
mild they can go unnoticed. However, in some cases, a listeria infection can lead to life-
 threatening complications, including: Generalized blood infection. Inflammation of the
membranes and fluid surrounding the brain (meningitis)

8. What is 16s rDNA PCR used for? 16S ribosomal RNA (rRNA) gene polymerase
chain reaction (PCR) is used for detection and identification of bacterial pathogens in
clinical specimens from patients with a high suspicion for infection.

9. What are symptoms of enteric viral infections? Worldwide, a diverse group of

viral, bacterial, and parasitic pathogens cause acute enteric symptoms including nausea,
vomiting, abdominal pain, fever, and acute diarrhea.

is there often blood? What are the treatments? Based on the safety
profile, expanded-spectrum cephalosporins or azithromycin should be the first-line
therapy for bacterial enteric infections during pregnancy if antimicrobials are required,
depending on the organism and the results of susceptibility testing (BIII).

10. How is norovirus transmitted? You can get norovirus by accidentally getting tiny
particles of feces (poop) or vomit from an infected person in your mouth. have
direct contact with someone who is infected with norovirus, such as by caring for them or
sharing food or eating utensils with them. How many infectious particles can cause
disease? Noroviruses are highly contagious and 10-100 viral particles may be sufficient
to infect an individual.
What are the symptoms? Diarrhea, stomach pain and vomiting, diarrhea, and
stomach cramping. Less common symptoms can include low-grade fever or chills,
headache, and muscle aches., typically begin 12 to 48 hours after exposure. Norovirus
symptoms usually last one to three days, and most people recover completely without
treatment.
What are complications? Norovirus infection can cause severe dehydration,
malnutrition and even death, especially in people who are older or
immunocompromised, or in women who are pregnant. Warning signs of dehydration
include Fatigue. Dry mouth and throat.
11. What are the main features of virus structure? The simplest virions consist of two basic
components: nucleic acid (single- or double-stranded RNA or DNA) and a protein
coat, the capsid, which functions as a shell to protect the viral genome from nucleases
and which during infection attaches the virion to specific receptors exposed on the
prospective host cell. Each virus is a nucleic acid (RNA or DNA) surrounded by a
coating, referred to as an envelope or capsid. Viruses encode capsid proteins which
encase the nucleic acid. Sometimes, viral proteins combine with host proteins to
make the envelope. The shape of a viral coat has implications on how a virus infects a
host.
How are viruses different from bacteria? the main difference is that bacteria are free-
living cells that can live inside or outside a body, while viruses are a non-living
collection of molecules that need a host to survive

12. What viruses cause the common cold? Rhinovirus

13. How is coxsackie transmitted? The virus is spread by direct contact with nose
and throat discharges, blisters and feces of infected people. What are the
 symptoms? The most frequent signs and symptoms of coxsackievirus infections are
initially fever, a poor appetite, and respiratory illness, including sore throat, cough,
and malaise (feeling tired). This incubation period lasts about one to two days.
What are complications? Occasionally, coxsackieviruses can cause more serious
infections that may need to be treated in a hospital, including: viral meningitis, an
infection of the meninges (membranes that surround the brain and spinal cord)
encephalitis, a brain infection. myocarditis, an infection of the heart muscle.
14. How is influenza transmitted? The influenza viruses mainly are spread from person to
person through droplets produced while coughing or sneezing. Droplets of an
infected person are propelled by coughing, sneezing, and talking into the air and are
deposited on the mouth or nose of people nearby.

How does it infect cells? The influenza virus enters the host cell by having its
hemagglutinin bind to the sialic acid found on glycoproteins or glycolipid receptors of the
host. The cell then endocytoses the virus. In the acidic environment of the endosomes,
the virus changes shape and fuses its envelope with the endosomal membrane.

How does it get away from cells? After the vRNPs have left the nucleus, all that is left
for the virus to do is form viral particles and leave the cell. Since influenza is an
enveloped virus, it uses the host cell's plasma membrane to form the viral particles
that leave the cell and go on to infect neighbouring cells.

What are the symptoms? fever* or feeling feverish/chills.

 cough.
 sore throat.
 runny or stuffy nose.
 muscle or body aches.
 headaches.
 fatigue (tiredness)
 some people may have vomiting and diarrhea, though this is more common in
children than adults.
What are complications? Complications of flu can include bacterial pneumonia, ear infections,
sinus infections and worsening of chronic medical conditions, such as congestive heart failure,
asthma, or diabetes. What are the Treatments? But if you have a severe infection or are at
higher risk for complications, your doctor may prescribe an antiviral drug to treat the flu. These
drugs can include oseltamivir (Tamiflu), zanamivir (Relenza), peramivir (Rapivab) or baloxavir
(Xofluza)

15. . How is RSV transmitted? RSV is spread through contact with droplets from
the nose and throat of infected people when they cough and sneeze. RSV can
also spread through dried respiratory secretions on bedclothes and similar items.
What are the symptoms? Runny nose.
Decrease in appetite, Coughing. Sneezing, Fever Wheezing. What are
complications? In high-risk babies, RSV can lead to severe respiratory illness
and pneumonia. This may become life-threatening. RSV as a baby may be linked to
asthma later in childhood. Babies at high risk for RSV receive a medicine called
palivizumab. What if RSV goes untreated? For most healthy infants without a heart or
lung condition, RSV is similar to the common cold. In children with a weaker immune
system, untreated RSV can cause pneumonia or bronchiolitis (swelling of the
smaller airways in the lungs). Sometimes these children have to stay in the hospital.
Is there a treatment? No medication treats the virus itself. So caring for a baby with
RSV infection involves treating the symptoms and how it affects your baby's respiratory
system. Most babies and young children can be cared for at home: Remove sticky nasal
fluids with a bulb syringe and saline drops.
16. How is parvovirus B19 transmitted? Parvovirus B19—which causes fifth disease—
spreads through respiratory secretions, such as saliva, sputum, or nasal mucus, when
an infected person coughs or sneezes. What are the symptoms? malaise, headache,
myalgia, nausea, and rhinorrhea; typically beginning 5-7 days after initial infection.
What are complications? But for some people, parvovirus B19 infection can cause
serious health complications, such as chronic anemia that requires medical treatment.
You may be at risk for serious complications from fifth disease if you have a weakened
immune system caused by leukemia, cancer, organ transplants, or HIV infection.

17. What are the viruses associated with childhood infections? Cold. About 52.2 million
colds are endured by children in America annually. ...Respiratory Syncytial Virus
(RSV) ...Roseola. ...Gastroenteritis. ...Hand-Foot-Mouth Disease. ...Fifth
Disease. ...Group A Strep. ...Influenza.
18. What is a dermatophyte infection? A dermatophyte infection, also known as
dermatophytosis or tinea, refers to a group of fungal infections that can affect
the skin, hair, and nails. Tinea infections are one of the most common causes of
superficial fungal infections around the world and are distinguished by the area of
the body affected. How are they transmitted? Dermatophytes are spread
by direct contact from other people (anthropophilic organisms), animals
(zoophilic organisms), and soil (geophilic organisms), as well as indirectly from
fomites. What are the symptoms? Symptoms of dermatophytoses
include rashes, scaling, and itching. Doctors usually examine the affected area
and view a skin or nail sample under a microscope or sometimes do a culture.
What are complications? The main complication is secondary bacterial
infection. Hair loss is a complication of tinea capitis. Pain and difficulty with
shoes can result from onychomycosis. Scarring is uncommon but more likely in
people with pigmented skin
19. What are lice, ticks and mosquitoes? They are insects. Are they microbes?
No. but they carry disease that can cause germs in humans.
20. How are specimens collected (containers) and stored until processing?
What is Q scoring? Q score” which is used to determine the. quality of the
specimen and the extent of culture workup
21. What are nematodes? The nematodes or roundworms constitute the phylum Nematoda
(also called Nemathelminthes), with plant-parasitic nematodes being known as eelworms.
How are they different from cestodes? Nematodes and Cestodes are worm
 groups. The key difference between Nematodes and Cestodes is that Nematodes are
roundworms whereas Cestodes are flatworms.
How are they different from Trematodes? Nematodes have a simple body form,
often referred to as a "tube within a tube," with a simple digestive system that
extends from the mouth at one end to the anus at the other. Trematodes have flat,
unsegmented bodies usually shaped like a leaf or an oval. Nematodes have two
sexes and reproduce sexually
22. . How do yeast grow? Yeast typically grow asexually by budding. A small bud
which will become the daughter cell is formed on the parent (mother) cell, and
enlarges with continued grow. As the daughter cell grows, the mother cell
duplicates and then segregates its DNA. The nucleus divides and migrates into
the daughter cell. What are dimorphic fungi? Dimorphic fungi are fungi that
can switch between yeast and mold, depending upon the environmental
conditions. For example, let's say a fungus is in the yeast form, but the
temperature cools, thus creating an environment that is conducive to mold. What
kind of a microbe are yeast? Yeast are single-celled microorganisms that are
classified, along with molds and mushrooms, as members of the Kingdom Fungi.
Yeasts are evolutionarily diverse and are therefore classified into two separate
phyla, Ascomycota or sac fungi
23. What is differential medium? Differential media contain compounds that allow
groups of microorganisms to be visually distinguished by the appearance
of the colony or the surrounding media, usually on the basis of some
biochemical difference between the two groups. How is it used? Differential media
are used to differentiate closely related organisms or groups of organisms.
Owing to the presence of certain dyes or chemicals in the media, the organisms
will produce characteristic changes or growth patterns that are used for
identification or differentiation.
24. What is chelitis? Cheilitis is the term that denotes inflammation of the lips.
Cracking, fissuring, reddening, peeling, and pain of the lips can occur when
inflammation is present. Inflammation of the lips can be caused by many different
conditions; in some cases, the condition can be chronic.
25. How is Cryptococcus neoformans transmitted? Cryptococcosis is caused by a
fungus known as Cryptococcosis neoformans. The infection may be spread to
humans through contact with pigeon droppings or unwashed raw fruit.
Contact with an infected individual may also spread the infection. What are the
symptoms? In general, symptoms of various forms of cryptococcosis may
include: chest pain, dry cough, headache, nausea, confusion, blurred or
double vision, fatigue, fever, unusual and excessive sweating at night,
swollen glands without the appearance of infection in nearby areas, skin rash,
pinpoint red spots. What are complications? The most common neurological
manifestation of Cryptococcus neoformans infection is meningitis. Other less
common manifestations include parenchymal central nervous system (CNS)
granulomatous disease, hydrocephalus and stroke.
26. How is Trichomonas vaginalis transmitted? Trichomoniasis is caused by a
parasite called Trichomonas vaginalis that can live in semen or vaginal fluids.
It spreads during unprotected anal, oral, or vaginal sex, usually between a
 man and a woman or between two women. What are the symptoms? Itching,
burning, redness or soreness of the genitals, Discomfort with urination, A change
in their vaginal discharge (i.e., thin discharge or increased volume) that can be
clear, white, yellowish, or greenish with an unusual fishy smell. What are the
complications? Trichomoniasis can increase the risk of getting or spreading
other sexually transmitted infections. For example, trichomoniasis can cause
genital inflammation that makes it easier to get infected with HIV, or to pass the
HIV virus on to a sex partner.
27. How is Plasmodium transmitted? The plasmodium parasite is spread
by female Anopheles mosquitoes, which are known as "night-biting"
mosquitoes because they most commonly bite between dusk and dawn. If a
mosquito bites a person already infected with malaria, it can also become infected
and spread the parasite on to other people. What are symptoms? fever and flu-
like illness, including shaking chills, headache, muscle aches, and tiredness.
Nausea, vomiting, and diarrhea may also occur. What are the complications?
Liver and kidney failure, jaundice, acute respiratory illness, premature birth – birth
before 37 weeks of pregnancy, low birth weight, restricted growth of the baby in
the womb, stillbirth, miscarriage, and death of the mother.

28. . What are the classic signs of inflammation? Based on visual observation, the
ancients characterised inflammation by five cardinal signs, namely redness
(rubor), swelling (tumour), heat (calor; only applicable to the body'
extremities), pain (dolor) and loss of function (functio laesa).

29. What is beta hemolysis? represents a complete breakdown of red blood cells,
demonstrated by a complete clearing of red blood cells around a colony. Which
microbes are able to do this? Streptococcus pyogenes and some strains of
Staphylococcus aureus. What virulence factor do they have that would do
this? The capsule serves as the major virulence factor, enabling the
pneumococcus to resist phagocytic engulfment, and glycopeptides from its Gram-
positive cell wall can lead to excessive cytokine production and a massive
inflammatory response. Pneumococci show alpha hemolysis on Blood agar.

30. What is a zone of inhibition? The Zone of inhibition is a circular area around
the spot of the antibiotic in which the bacteria colonies do not grow. The
zone of inhibition can be used to measure the susceptibility of the bacteria to
wards the antibiotic. What does it tell you? The Zone of inhibition is a circular
area around the spot of the antibiotic in which the bacteria colonies do not grow.
The zone of inhibition can be used to measure the susceptibility of the bacteria
to wards the antibiotic. The size of the zone of inhibition is usually related to
the level of antimicrobial activity present in the sample or product - a larger
zone of inhibition usually means that the antimicrobial is more potent. Why would
you look for this? zone of inhibition: This is an area of media where bacteria
are unable to grow, due to presence of a drug that impedes their growth.
minimum inhibitory concentration: This is the lowest concentration of an
 antimicrobial drug that prevents visible growth of a microorganism after overnight
incubation with media.

31. What is the Infection Prevention and Control (IPAC) program? Infection
Prevention and Control (IPAC) refers to evidence-based practices and
procedures that, when applied consistently in health care settings, can prevent or
reduce the risk of transmission of microorganisms to health care providers,
clients, patients, residents and visitors.

32. What is the basic reproduction number? The basic reproduction number (R0) is the
number of cases directly caused by an infected individual throughout his infectious period.
What can it be used for? The basic reproduction number (R0) is used to measure the
transmission potential of a disease. It is the average number of secondary infections
produced by a typical case of an infection in a population where everyone is
1
susceptible. For example, if the R0 for measles in a population is 15, then we would
expect each new case of measles to produce 15 new secondary cases (assuming
everyone around the case was susceptible). R0 excludes new cases produced by the
secondary cases.

33. What does multidrug resistance mean? When a single bacterium is resistant to
more than one antibiotic it is said to be multidrug-resistant. This can occur in
two distinct ways. A bacterium can have several different resistance genes, each
providing resistance to a particular antibiotic. What is MRSA? Methicillin-resistant
Staphylococcus aureus (MRSA) infection is caused by a type of staph bacteria that's become
resistant.

34. . What is infectivity? In epidemiology, infectivity is the ability of a pathogen to

establish an infection. ... This means that as a pathogen's ability to infect a
greater number of hosts increases, so does the level of harm it brings to the host.
How is it calculated? Knowing just the numbers of infections identified by
surveillance activities is not sufficient to identify the risk (probability) of infection
occurring in the facility residents; rates must be used. An incidence rate is typically used
to measure the frequency of occurrence of new cases of infection within a defined
population during a specified time frame. # of Infections Population at Risk X constant (k)
= Rate of Infection The “number (#) of infections” is the cases identified by surveillance
activities (for example five UTIs), during a defined time frame in a defined population.
The “population at risk” would be all the patients in the facility during the time frame
when surveillance occurs (for example, 120 patients - average daily census- in the facility
in April). The “constant or K” is usually an assigned value of 100, 1,000, 10,000 or
100,000, which represents a standard population and time period for interpretation of the
rate. Using 100 as the “K” will give an infection rate that may be expressed as a
percentage. For example, to find the percentage of residents with a UTI infection in April
in the facility: 5 UTIs 120 Residents (average daily census) X 100 = 4.2% UTI rate in
April.

35. How is Zika virus transmitted? Zika virus is transmitted to people

primarily through the bite of an infected Aedes species mosquito (Ae. aegypti
 and Ae. albopictus). These are the same mosquitoes that spread dengue and
chikungunya viruses. What are the symptoms? Headache, muscle pain, eye
pain, fatigue and general feeling discomfort and abdominal pain. What are the
complications? Zika infection during pregnancy can cause serious birth
defects and is associated with other pregnancy problems. Rarely, Zika may
cause Guillain-Barré syndrome, an uncommon sickness of the nervous system in
which a person's own immune system damages the nerve cells, causing muscle
weakness, and sometimes, paralysis.

36. How is Hepatitis B transmitted? Hepatitis B is spread when blood, semen, or

other body fluids from a person infected with the virus enters the body of
someone who is not infected. This can happen through sexual contact; sharing
needles, syringes, or other drug-injection equipment; or from mother to baby at
birth. What are the symptoms? Fever, abdominal pain, clay-coloured bowel,
nausea, vomiting and dark urine. What are the complications? including liver
damage, liver failure, liver cancer, and even death. Who gets the vaccine?
Anyone 18 years of age or younger who has not previously received the
hepatitis B vaccine should get it. Children adopted from countries where HBV
infection is common should be tested for hepatitis B and get shots if they are not
immune. What kind of a vaccine is it? Twinrix (trade name is recombivax)

37. What is the MMR vaccine? The MMR vaccine is a vaccine against measles, mumps,
varicella, and rubella. The first dose is generally given to children around 9 months to 15
months of age, with a second dose at 15 months to 6 years of age, with at least 4 weeks
between the doses. How is it made? Measles vaccines are made using what's
called an attenuated virus. That means it's been weakened in the lab. It's grown
in cultures of chick embryos — basically, unhatched live eggs. Lots of vaccines
are grown that way — it's old-fashioned technology but it works.

38. What are the main types of vaccines? (Live, attenuated) examples:
Measles, mumps, rubella (MMR combined vaccine)
Varicella (chickenpox)
Influenza (nasal spray)
Rotavirus

(Inactivated/Killed vaccine): Polio (IPV) Hepatitis A

Toxoid (inactivated toxin): Diphtheria, tetanus (part of DTaP

combined immunization)

Subunit/conjugate: Hepatitis B, Influenza (injection), Haemophilus

influenza, type B(Hib), Pertussis (part of DTaP combined
immunization), Pneumococcal and Meningococcal.
 39. What is different between the antibodies made during the first
and second exposure? The primary antibody detects the antigen in the
specimen, but the secondary antibody can be designed to have a fluorophore or
enzyme complex attached to it for the purposes of visualization.

40.. What is passive immunity? Passive immunity is the transfer of active humoral
immunity of ready-made antibodies. Passive immunity can occur naturally, when maternal
antibodies are transferred to the fetus through the placenta,

41.What is the difference between primary and secondary

immunodeficiencies? Primary immunodeficiencies are the result of genetic
defects, and secondary immunodeficiencies are caused by environmental
factors, such as HIV/AIDS or malnutrition.

42.. If someone has a splenectomy are they susceptible to certain

infections? After spleen removal, you're more likely to contract serious or life-
threatening infections. Your doctor may recommend that you receive vaccines
against pneumonia, influenza, Haemophilus influenzae type b (Hib) and
meningococci.

43.What are complement proteins important for? The complement

system is made up of a large number of distinct plasma proteins that react with
one another to opsonize pathogens and induce a series of inflammatory
responses that help to fight infection. A number of complement proteins are
proteases that are themselves activated by proteolytic cleavage. The complement
system helps antibodies and phagocytic cells clear pathogens from an
organism. The complement system consists of a number of small proteins
produced by the acute phase reaction in the liver during inflammation.

44.What happens if someone doesn’t have lymphocytes? A low

lymphocyte count makes it hard for your body to fight infections. You may get
infections caused by viruses, fungi, parasites, or bacteria. Treatment for an
infection will depend on its cause. You also may need treatment after an infection
is gone to help prevent repeat infections. T cells vs B cells missing? An
important difference between T-cells and B-cells is that B-cells can connect to antigens
right on the surface of the invading virus or bacteria. This is different from T-cells, which
can only connect to virus antigens on the outside of infected cells.

45.What are the 4 types of hypersensitivities and the main

players?
The four types of hypersensitivity are:
 Type I: reaction mediated by IgE antibodies.
 Type II: cytotoxic reaction mediated by IgG or IgM antibodies.
  Type III: reaction mediated by immune complexes.
 Type IV: delayed reaction mediated by cellular response.
Which is IgE associated with? IgE is an immunoglobulin that plays a central role
in acute allergic reactions and chronic inflammatory allergic diseases. The
development of a drug able to neutralize this antibody represents a breakthrough in the
treatment of inflammatory pathologies with a probable allergic basis.
46. What is beta hemolysis? Beta hemolysis. represents a complete breakdown of
red blood cells, demonstrated by a complete clearing of red blood cells around a
colony.
47. . What is MacConkey medium useful for? MacConkey agar is used for the
isolation of gram-negative enteric bacteria. It is used in the differentiation of
lactose fermenting from lactose non-fermenting gram-negative bacteria. It is used
for the isolation of coliforms and intestinal pathogens in water, dairy products and
biological specimens.
48. What is chocolate agar made of? Chocolate agar is prepared by heating blood
agar, which in turn ruptures the red blood cell (RBC) and releases nutrients that
aid in the growth of fastidious bacteria, most notably Haemophilus and Neisseria
species. The name is derived from the fact that the lysis of RBC gives the medium
a chocolate-brown color.
49. What are point of care tests? How sensitive are they? Point-of-care tests are
diagnostic tests performed at or near the place where a specimen is
collected, and they provide results within minutes rather than hours.
These may be NAAT, antigen, or antibody tests.

Rapid point-of-care tests provide results within minutes (depending on the

test) and are used to diagnose current or detect past SARS-CoV-2 infections
in various settings, such as doctor’s offices, emergency care

50. What does a Gram stain tell you? A Gram stain is a laboratory procedure used
to detect the presence of bacteria and sometimes fungi in a sample taken
from the site of a suspected infection. It gives relatively quick results as to
whether bacteria or fungi are present and, if so, the general type(s)
How is Lyme transmitted? The Lyme disease bacterium, Borrelia burgdorferi, is spread
through the bite of infected ticks. The blacklegged tick (or deer tick, Ixodes
scapularis) spreads the disease in the northeastern, mid-Atlantic, and north-central
United States. What are the symptoms? Fever, bull eye rash, sleeping difficulty,
lethargy, joint pain, peripheral neuropathy, light sensitivity, cognitive decline, Lyme
carditis. What are the complications? Neurological complications most often occur in
the second stage of Lyme disease, with numbness, pain, weakness, Bell's palsy
(paralysis of the facial muscles), visual disturbances, and meningitis symptoms such as
fever, stiff neck, and severe headache. Are there any treatment? Yes. If Lyme is
diagnosed or suspected, a doctor will prescribe antibiotic treatment for 2-3
weeks. Sometimes a course of 28 days or longer might be recommended. This
can work for some people.

This treatment is usually more effective when Lyme is detected in its earliest
stages and hasn’t settled into the organs and tissues of the body. If Lyme is in its
later stages of development, it may not be effective at all.

51. How is West Nile Virus transmitted? West Nile virus is most commonly spread
to people by the bite of an infected mosquito. Mosquitoes become infected
when they feed on infected birds. What are the symptoms? Symptoms of severe
illness include high fever, headache, neck stiffness, stupor, disorientation,
coma, tremors, convulsions, muscle weakness, vision loss, numbness and
paralysis. Severe illness can occur in people of any age; however, people over
60 years of age are at greater risk.
52. How is Babesia transmitted? How do people get infected with Babesia? The
main way is through the bite of an infected tick. Babesia microti is spread by
Ixodes scapularis ticks, which are commonly called blacklegged ticks or deer
ticks. What are the symptoms? Some people develop flu-like symptoms, such
as fever, chills, sweats, headache, body aches, loss of appetite, nausea, or
fatigue. Because Babesia parasites infect red blood cells, babesiosis can cause
hemolytic anemia (from the destruction of red blood cells). What are the
complications? Forty-one percent of patients with Babesia developed
complications such as acute respiratory failure, disseminated intravascular
coagulation, congestive heart failure, and renal failure. Where is it most likely
found in a human? Human babesiosis is an emerging intraerythrocytic infection
caused by protozoal parasites and transmitted by Ixodid ticks. Babesiosis is
endemic in the northeastern and upper midwestern regions of the United
States and found sporadically in other parts of the United States, Europe,
Asia, Africa, and South America.

Is it common here in NS? Nova Scotia has a suitable climate for tick
populations. Blacklegged ticks survive best in areas that provide a moist habitat
and are often found in and near wooded or forested areas, shrubs, long grass,
leaf litter, urban parks and gardens. Adult blacklegged ticks are most active in
the spring and fall.

53. How is Rocky Mountain Spotted Fever transmitted? Rocky Mountain spotted
fever (RMSF) is a bacterial disease spread through the bite of an infected tick.
Most people who get sick with RMSF will have a fever, headache, and rash.
RMSF can be deadly if not treated early with the right antibiotic.

What are the symptoms?

Signs and symptoms can include:

  Fever.
 Headache.
 Rash.
 Nausea.
 Vomiting.
 Stomach pain.
 Muscle pain.
 Lack of appetite.

What are the complications? If untreated, serious complications, including nerve

damage, hearing loss, incontinence, partial paralysis, and gangrene of toes or
fingers,

54. How is Rabies transmitted? Rabies virus is transmitted through direct

contact (such as through broken skin or mucous membranes in the eyes, nose,
or mouth) with saliva or brain/nervous system tissue from an infected animal.
People usually get rabies from the bite of a rabid animal.

What are the symptoms?

he first symptoms of rabies may be very similar to those of the flu and may last for days.
...
Later signs and symptoms may include:
 Fever.
 Headache.
 Nausea.
 Vomiting.
 Agitation.
 Anxiety.
 Confusion.
 Hyperactivity.

What are the complications?

Common complications of rabies include, psychosis, seizures, aphasia, muscular

twitching, delirium and death. Treatment after exposure (receiving the vaccines),
known as post-exposure prophylaxis (PEP), is highly successful in preventing the
disease if administered promptly, in general within ten days of infection.

55. . How is Diphtheria transmitted? Diphtheria bacteria spread from person to

person, usually through respiratory droplets, like from coughing or sneezing.
People can also get sick from touching infected open sores or ulcers.
Symptoms of diphtheria
 a thick grey-white coating at the back of your throat.
 a high temperature (fever) of 38C or above.
 feeling sick.
 sore throat.
 headache.
 swollen glands in your neck.
 difficulty breathing and swallowing.

What are the complications?

What are the complications of diphtheria?

 Respiratory failure due to pseudomembrane formation or aspiration, tissue
edema, and necrosis.
 Cardiac - Myocarditis, cardiac dilatation and failure, mycotic aneurysm,
endocarditis.
 Rhythm disturbances - Heart block, including AV dissociation and dysrhythmias.
56. How is plague transmitted? Bubonic plague is transmitted through the bite of
an infected flea or exposure to infected material through a break in the skin.
Symptoms include swollen, tender lymph glands called buboes.
Symptoms
 Bubonic plague: Patients develop sudden onset of fever, headache, chills, and
weakness and one or more swollen, tender and painful lymph nodes (called
buboes). ...
 Septicemic plague: Patients develop fever, chills, extreme weakness, abdominal
pain, shock, and possibly bleeding into the skin and other organs.
Complications of plague may include:
 Death. Most people who receive prompt antibiotic treatment survive bubonic
plague. ...
 Gangrene. Blood clots in the tiny blood vessels of your fingers and toes can
disrupt blood flow and cause that tissue to die. ...
 Meningitis.

57. How do enzyme immunoassay (EIA) tests work? During EIA the process uses
enzyme labelled antibodies and antigens to detect the small biological molecules
required. The technique makes use of the basic immunology concept that an antigen
binds a specific antibody. What are monoclonal antibodies? A monoclonal antibody is
an antibody made by cloning an unique white blood cell. All subsequent antibodies derived
this way trace back to a unique parent cell. Monoclonal antibodies can have monovalent
affinity, binding only to the same epitope.
58. How are monoclonal antibodies generated compared to polyclonal?
 Antibodies, also known as immunoglobulins, are secreted by B cells to neutralize
antigens such as bacteria and viruses. The classical representation of an antibody
is a Y-shaped molecule composed of four polypeptides-two heavy chains and two
light chains. Each tip of the “Y” contains a paratope (a structure analogous to a
lock) that is specific for one particular epitope (similarly analogous to a key) on an
antigen, allowing these two structures to bind together with precision. The ability
of binding to an antigen has led to their ubiquitous use in a variety of life science
and medical science. These antibodies can be classified into two primary types
(monoclonal and polyclonal) by the means in which they are created from
lymphocytes. Each of them has important role in the immune system, diagnostic
exams, and treatments.
59. How is the Mantoux test done? The TB skin test, also known as the Mantoux test,
tells if your body has been exposed to the TB germ. The nurse will inject a
small amount of fluid just under the skin of the left forearm. You will see a little
bubble or blister appear right away at the injection site. This is normal and it will
soon disappear.
What does positive test look like? If there is a reaction, some redness and a small
bump will appear on the arm. A measurement of 10 millimetres or more is "positive",
and means you may have the TB germ in your body. At that point, the nurse will request
additional information and tests, including chest x-ray and the collection of sputum
samples.
60. . How is Tularemia transmitted? tularensis bacteria can be transmitted to humans via the
skin when handling infected animal tissue. In particular, this can occur when hunting
or skinning infected rabbits, muskrats, prairie dogs and other rodents.
What are the symptoms?
Signs and symptoms include:
 Fever.
 Throat pain.
 Mouth ulcers.
 Abdominal pain.
 Vomiting.
 Diarrhea.
 Inflamed tonsils.
 Swollen lymph nodes in the neck.
What are the complications?
Other possible complications include:
 Inflammation of the lungs (pneumonia). ...
 Infection around the brain and spinal cord (meningitis). ...
 Irritation around the heart (pericarditis). ...
 Bone infection (osteomyelitis).
When treated promptly, tularemia seldom has long-term effects. If it is
untreated or if treatment is delayed, the infection may affect any part of the body,
causing: Lung problems, such as pneumonia. Damage to the cornea of the eye.