Answer Key

Influenza Microbiology and Evolution

1. Following are TRUE or FALSE.
   1. There are three types of influenza virus. TRUE.
   2. Influenza C is the deadliest of all three types. FALSE.
   3. A virus or bacteria usually cause the stomach flu. TRUE.
   4. As humans, we mutate much quicker than RNA viruses. FALSE.
   5. RNA viruses mutate about once every 30 years. FALSE.
2. Which of the following is NOT a member of the orthomyoxviruses family?
   1. Influenza A
   2. Influenza B
   3. Influenza C
   4. Influenza D
3. What is located in the center of the influenza virus?
   1. Lipid bilayer
   2. RNA
   3. Hemagglutinin
   4. Neuraminidase
4. What determines the name of the specific influenza virus?
   1. The person who discovered it is able to name it
   2. The first patient who becomes ill is able to name it
   3. The number of molecules in the RNA
   4. The number of HA and NA on the surface
5. How often does a person need the flu shot?
   1. Monthly
   2. Every 6 months
   3. Yearly
   4. Daily
6. What happens when the influenza virus mutates?
   1. The RNA lengthens
   2. The number of HA and NA change
   3. The RNA shortens
   4. The lipid bilayer changes

Some Definitions and Pathogenesis

1. The following are symptoms of influenza (select all that apply).
   1. Cough
   2. Fever and Chills
   3. Swelling Ankles
   4. Headache
2. Virulence refers to the virus transmission. FALSE.
3. The following are common complications of an influenza bout(select all that apply).
   1. Croup
   2. Hepatic Failure
   3. Bacterial Pneumonia
   4. Heart Attack
4. Define pathogen:
   A pathogen is a biological microorganism that
   causes harm to its host.
   
5. Symptoms of influenza begin to show:
   1. Immediately on infection
   2. Within two to four hours of infection
   3. Within two to four days of infection
   4. Within two weeks of infection
6. When budding occurs the virus is released into the airways, spreading the infection. FALSE.

Influenza Epidemiology

1. Which of the following virus subtypes was responsible for the Spanish Flu (1918)?
   1. H1N1
   2. H3N2
   3. H2N2
   4. H5N1
2. Which of the following virus subtypes was responsible for the Hong Kong Flu (1968-1969)?
   1. H1N1
   2. H3N2
   3. H2N2
   4. H5N1
3. Which of the following virus subtypes was responsible for the Asian Flu (1958)?
   1. H1N1
   2. H3N2
   3. H2N2
   4. H5N1
4. Which of the following is an estimate of the number of people who die annually due to the flu in a regular flu season?
   1. 360
   2. 3,600
   3. 36,000
   4. 360,000
5. Which one of the following is not a known vector for transmission of the flu to humans?
   1. swine
   2. wild birds
   3. domesticated birds
   4. other humans
6. The avian flu virus is generally not deadly to birds. TRUE.
7. Most human cases of avian flu result from consuming meat from sick chickens. FALSE.
8. As of the year 2006, there have been ZERO cases of the bird flu in the United States. FALSE.

Treament and Prevention

1. Choose the influenza treatment that describes the biological mechanism of action. antihistamine, decongestant, Tamiflu, aspirin, amantadine
   1. This treatment is involved in vasoconstriction and reduction of fluid leaking from capillaries. __decongestant____
   2. This treatment is an enzyme inhibitor of cyclooxygenases which in turn decreases prostaglandin production. __aspirin___
   3. This treatment is an enzyme inhibitor of viral neuraminidase.___Tamiflu_____
2. The CDC recently recommended that amantadine and rimantadine not be used as treatment of influenza in the U.S. because
   1. they have severe side effects.
   2. the virus easily develops resistance to the drugs.
   3. there has not been sufficient research to show their effectiveness in treatment.
   4. the proper dosage has yet to be determined.
3. The reason that there is a new influenza vaccine produced every year is because
   1. the virus is constantly evolving into new strains.
   2. the vaccine has limited effectiveness if kept in storage too long.
   3. there are always several different strains of the virus that can infect a person.
   4. the vaccine causes too many people to have flu-like symptoms from year to year.
4. Vaccines prevent disease by
   1. causing the body to replicate the pathogen and "store" it in memory.
   2. infecting the body with a strong dose of the pathogen so that it can produce antibodies.
   3. causing the body to produce antibodies and memory cells against a small dose of injected pathogen.
   4. allowing a person to get ill with the disease in order to develop an immunity.
5. Briefly describe 3 surveillance methods for H5N1 vector control.
   a. Closely monitoring H5N1 outbreaks in birds and other vectors and taking quick action to contain the outbreaks. Specifying surveillance perimeters around bird farms
   b. Monitoring migratory bird route patterns. Are the birds coming from endemic areas? How many of them and where are they headed to?
   c. Keeping a good check on hygiene standards that are used in the poultry industry and advising on ways to prevent the spread of the virus among possible vectors
   
6. Compare two advantages and disadvantages for bird culling to prevent the spread of H5N1.
   Advantages - prevents the spread of the virus to other birds and humans, prevents possible epidemics and/or a pandemic
   Disadvantages - loss of economic revenue for bird farmers, humans being involved in the process of culling - possibly increasing risk of infection