1. In 1976, Carlton Gajdusek won the Nobel Prize for Medicine for his two decades of research on
(a) Kuru
(b) Typhoid fever
(c) Cholera
(d) Tuberculosis
(e) Bubonic plague

2. The Broad Street Pump became a source of cholera in 1854 London because
(a) It was supplied with water from the Southwark and Vauxhall Company
(b) It was supplied with water from the Lambeth company
(c) It was poorly situated so raw sewage spilled into it
(d) Relatively salty seawater seeped into it
(e) The pump handle was not properly sealed and airborne microbes fell into the well

3. Mary Mallon’s principal profession was
(a) Doctor
(b) Nanny
(c) Tennis player
(d) Cook
(e) Housewife

4. The epidemiologist most associated with the story of “Typhoid Mary” was
(a) Snow
(b) Soper
(c) Koch
(d) Petenkofer
(e) Yersin

5. The outbreak of cholera that began in 1854 near the Broad Street Pump (Golden Square, London) ended
(a) In 1854
(b) In 1855
(c) In 1860
(d) After the introduction of antibiotics
(e) Never. It continues to this day.

6. Which of these diseases killed the largest number of people in the year 2003?
(a) Kuru and Mad Cow Disease
(b) Typhoid fever
(c) Cholera
(d) Tuberculosis
(e) Bubonic plague

7. The most sterile (bacteria free) fluid of these is
(a) Saliva
(b) Sweat
(c) Urine
(d) Nasal discharge (“snot”)
(e) Diarrhea

8. A normal, healthy human being
(a) Carries no bacteria at all
(b) Carries only pathogenic bacteria and would be even healthier if they were all removed
(c) Carries only non-pathogenic bacteria and would be even healthier if they were all removed
(d) Carries a mix of pathogenic and non-pathogenic bacteria and would be even healthier if they were all removed
(e) Carries a mix of pathogenic and non-pathogenic bacteria and would be sicker if they were all removed

9. Which of these diseases is most likely spread by fecal-oral contamination?
(a) Creutzfeldt-Jakob Disease
(b) Typhoid fever
(c) Tuberculosis
(d) Bubonic plague
(e) Kuru

10. Which of these diseases is most likely spread by aerosol droplets from coughs and sneezes?
(a) Kuru
(b) Typhoid fever
(c) Tuberculosis
(d) Bubonic plague
(e) Mad Cow Disease

11. The city of Altona was spared the worst of the cholera epidemic that swept through the neighboring city of Hamburg in 1892 because
(a) The quarantine of Hamburg by Prussian troops was so effective
(b) Altona had a sewage treatment facility that collected all the raw sewage of the city for sterilization
(c) The population of Altona was not large enough to sustain a cholera epidemic
(d) The people of Altona had a healthier diet of well-cooked foods
(e) Altona filtered its water through sand before distributing it to houses

12. Which of the following diseases can be classified alongside other “spongiform encephalopathies” like BSE (“Mad Cow Disease”)?
(a) Typhoid fever
(b) Cholera
(c) Tuberculosis
(d) Bubonic plague
(e) Creutzfeldt-Jakob Disease

13. Death from cholera is caused by
(a) Cerebral hemorrhage
(b) Bacteria growing in the blood
(c) Lack of iron in the blood
(d) Dehydration
(e) Stroke

14. The first “healthy carrier” of typhoid fever identified in the US was
(a) Molly McGuire
(b) Mary Mallon
(c) Josephine Baker
(d) George Soper
(e) Alice Marble

15. The Black Death that struck Europe in the mid 14th century was a plague that originated in
(a) Africa
(b) Asia
(c) North America
(d) South America
(e) Scandinavia

16. One difference between bubonic and pneumonic plague is
(a) The bacterium that causes the disease
(b) The degree of dehydration they cause
(c) The route of infection that causes them
(d) One is asymptomatic
(e) One is modern and the other is ancient

17. Between 1850 and 1950 the incidence of typhoid fever in New York City dropped dramatically. Most of this decline was due to
(a) Provision of clean water
(b) Quarantine of healthy carriers
(c) Discovery and use of antibiotics
(d) Building a network of hospitals with trained nursing staff
(e) A cultural change where hand washing became common

18. What is quarantine?
(a) Treatment of a place with harsh chemicals and gases that kill germs
(b) Filtration of water through a bed of sand, clay, and/or charcoal
(c) Isolation of a sick person to prevent contact with healthy persons
(d) Replacement of body fluids lost during severe diarrhea
(e) Engulfment of a bacterium by a white blood cell (a “phagocyte”)

19. What did John Snow’s work with cholera show?
(a) That the causative agent is carried by water
(b) That salt is necessary for cholera to be infectious
(c) That cholera is caused by a bacterium
(d) That cholera is associated with shellfish
(e) That there have been at least seven different pandemics of cholera since 1817

20. The global pandemic of HIV/AIDS has led to a large increase in the number of early deaths from
(a) Typhoid fever
(b) Cholera
(c) Tuberculosis
(d) Bubonic plague
(e) Creutzfeldt-Jakob Disease

21. Typhoid Mary’s fate would have been much different if she had read and followed a sign that said
(a) Employees must wash hands before returning to work
(b) Spitting is prohibited
(c) Don’t eat oysters in months with an R in them
(d) Boil all water before drinking
(e) Make sure you put your correct section number on the scantron and especially the correct form number!

22. If you start with a single bacterium and it divides every twenty minutes, how many do you have after 4 hours?
(a) 4
(b) 12
(c) 28
(d) 80
(e) More than a thousand

23. Which of the following diseases is always fatal?
(a) Kuru
(b) Typhoid fever
(c) Cholera
(d) Tuberculosis
(e) Bubonic plague

24. During the cholera outbreak in London in 1854, John Snow noted that the water supplied by the Southwark and Vauxhall Company (S&V) contained more salt than the water supplied by the Lambeth Co. He also noted that those who drank the S&V water were more likely to get cholera than those who drank the Lambeth water. The significance of the salt content is that it suggested that
(a) Salt is a contributing factor to cholera susceptibility
(b) The S&V Co. took its water from further downstream than the Lambeth Co.
(c) The Lambeth Co. probably filtered their water whereas S&V did not (or did so rather ineffectively)
(d) Salt kills the cholera germ
(e) Cholera victims excrete more salt in their diarrhea than healthy people do in their normal urine and feces

25. “Typhoid Mary” claimed that she had never been sick with typhoid fever, yet she was clearly the source of the Oyster Bay outbreak of 1906. The explanation for this is that
(a) She carried the germs on her hands and clothes, but the germs never got inside her
(b) The actual cause of the outbreak was her use of water from a contaminated pump that she thought was pure
(c) She was lying
(d) She had experienced an asymptomatic case of typhoid fever
(e) She was not the cause of the outbreak, just a convenient scapegoat.

26. Over the past 4 to 5 billion years, biological evolution has resulted in an enormous diversity of life forms. Which of these was the first to appear on the planet?
(a) Bacteria
(b) Fungi
(c) Insects
(d) Dinosaurs
(e) Plants

27. (Careful, this question is a little tricky!) Sally was quite ill with disease “X.” She got better. Then a year or two later she fell ill again with the same disease. The disease is most likely
(a) Kuru
(b) Typhoid fever
(c) Cholera
(d) Tuberculosis
(e) Bubonic plague