Chapter 1Seeds of Destruction

Question: With respect to the use of biological agents, what is Sir Jeffrey Amherst known for? a. He was the first to use anthrax against an invading force.*b. The use of smallpox virus against Native American tribes c. Discovering the causative agent of plague d. The first to decree an order of quarantine in the Americas

Question: The 1972 Biological Weapons Convention is a follow on to the 1925 Geneva Protocol*True False

Question: What is biosecurity? a. Measures to protect from infection. b. Precautions to minimize risk of introducing an infectious agent into a population. c. Policies and measures to protect food supply and agricultural resources from contamination and attacks of bioterrorism*d. All of the above

Question: What was a primary goal of the US Biowarfare program? a. To kill as many people as possible b. To selectively kill soldiers*c. To incapacitate, rather than kill, as many of the enemy as possible d. To permanently contaminate enemy-held ground

Question: With respect to the use of biological agents, what is Sir Jeffrey Amherst known for? a. Developed the vaccine for anthrax b. The first to decree an order of quarantine in the Americas c. Discovering the causative agent of plague*d. The use of smallpox virus against native American tribes

Question: Who was the infamous leader of Unit 731? a. Anand Puja*b. General Shiro Ishii c. Asahara Shoko d. Ken Alibek

Question: With reference to biological warfare, who said in 1969 “Mankind already carries in its own hands too many of the seeds of its own destruction.” a. General Alexander Haig b. Nikita Khrushchev *c. President Richard M. Nixon d. President John F. Kennedy

Question: Germination, vegetation, sporulation, _______, and weaponization are the 5 basic steps to making spore-forming bacteria into an effective bioweapon. a. Extraction b. Mixing*c. Separation d. Plating

Question: Who were the first persons to be tried and convicted under the 1989 Biological Weapons Anti-Terrorism Act? *a. Four Minnesota men for the possession of ricin b. Ted Hatfill c. Robert Alberg d. Ken Alibekov

Question: Which of the following diseases were used by the Germans in World War I against the Allied horse and mule population? SELECT ALL THAT ALLPY*a. Glanders*b. Anthrax c. Foot and Mouth Disease d. Karnal Bunt

Question: Beside Bacillus anthracis, Aum Shinrikyo dabbled with a number of biological agents. What else did they experiment with? a. Botulinum toxin b. Cholera c. Q fever*d. All of the above

Essay Question: When President Nixon said that “Mankind already holds in its hands too many of the seeds of its own destruction” in November, 1969, what did he mean by that?

Essay Question: No one knows exactly who perpetrated the Anthrax attacks of 2001 and there hasn’t been a repeat of them since. Discuss the reasons why we haven’t we seen any repeat of the anthrax attacks since 2001.

Essay Question: Discuss the difference between biodefense and biosecurity.

Essay Question: What is a zoonotic disease?

Chapter 2Recognizing the Threat

Question: Viruses are larger than bacteria and capable of metabolism. a. True*b. False

Question: A sign indicates the presence of a disease; a symptom is a change from normal function, sensation, or appearance, generally indicating disease or disorder.  Typically, we see signs of disease and patients explain or describe their symptoms.*a. True b. False

Question: What is the science concerned with the study of microscopic changes in diseased tissues?*a. Histopathology b. Serology c. Culturing d. “Gold Standard” testing

Question: With respect to disease and clinical presentation, a sign is something that the patient explains to the practitioner as an abnormal feeling or condition (e.g., aches and pains). a. True*b. False

Question: Rickettsia are small, Gram-negative bacteria that require a host cell.*a. True b. False

Question: The goal of ____________________ treatment is to keep exposed individuals from becoming symptomatic and infectious to others, thereby reducing the chances that infection will spread amongst the population. Answer: prophylactic

Question: What is a prion? a. a fungal disease of the brain b. a small virus*c. a proteinaceous infectious particles d. the first stage in the TDS

Question: Viruses are capable or metabolizing nutrients and contain only DNA as their genetic material. True*False

Question: What is the term that refers to the timeframe from exposure-to-infection-to-illness? a. virulence b. pathogenicity*c. incubation period d. all of the above

Question: Ricin is an example of a ____________. Answer: toxin

Question: What is the second stage of the Tiered Diagnostic System? a. Confirmed b. Suspected c. Differential*d. Probable

Essay Question: Some have opined that biological weapons are more weapons of mass distraction than weapons of mass destruction. What is meant by this?

Essay Question: Discuss the advantages and disadvantages of using biological agents as a weapon. In doing so, think like a terrorist!

Essay Question: What is a tiered diagnostic system? Explain how this fits in with a differential diagnosis.

Essay Question: What are the four routes of entry whereby a biological agent may gain access to a host? Which one of the four is the most important when it comes to bioweapons development? Explain your selection.

Chapter 3Category A Agents and Diseases

Question: Bacillus anthracis is the etiologic agent of what disease? a. Q Fever*b. Anthrax c. Plague d. Glanders

Question: What is the etiologic agent of Tularemia?*a. Francisella tularensis b. Coxiella burnetii c. Variola minor d. Brucella suis

Question: What is the etiologic agent of Plague? a. Bacillus anthracis b. Shigella flexneri*c. Yersinia pestis d. Pasteurella plaguensis

Question: Before October 2001, the last case of inhalational anthrax in the United States occurred in what year? a. 1924*b. 1976 c. 1998 d. There has never been a case in the US

Question: A single case of smallpox in the United States would: a. Automatically trigger NIMS b. Constitute an international crisis c. Bring about programs for quarantine and ring vaccination*d. All of the above

Question: What is the name of Russia’s official smallpox virus repository? a. Biopreparat*b. Vector c. Sverdlovsk d. Yevgenia

Question: Botulism can be spread from one person to another. a. True*b. False

Question: Plague occurs naturally in the United States east of the Mississippi River. a. True*b. False

Matching Question: Match the agent on the left with the attribute on the right.

Match Question Items Answer ItemsB. - A.  Yersinia pestis A.  The causative agent of a disease that has been eradicated

 E. - B.  Bacillus anthracis B.  The agent of the Black Death C. - C.  Clostridium

botulinum C.  A bacteria which produces the most toxic substance known to humans

D. - D.  Francisella tularensis

D.  One of the most infectious bacteria known – causes rabbit fever

A. - E.  Variola major E.  Kills cattle every year in the US and was the agent used in the letters of 2001

Question: Which attribute is one of the criteria for a Category A agent? a. Easily disseminated b. Could cause fear, panic or social disruption c. Presents special actions for public health *d. All of the above

Question: What produces Botulinum toxin? a. Amanita Mushrooms b. Castor Bean plant*c. Clostridium botulinum d. Clostridium perfringens

Question: The last documented person-to-person transmission of pneumonic plague occurred when and where in the US? a. Tulare County, CA; 1907 b. Long Island, NY; 1888 c. Dallas, TX; 1956*d. Los Angeles, CA; 1924

Question: With a large outbreak of pneumonic plague contact management would be very challenging. What constitutes a contact? a. Those infected with Yersinia pestis*b. Anyone who has come within 2 meters of a coughing plague patient within 7 days c. Anyone that’s an acquaintance of a plague case patient d. An exposed person that refuses prophylaxis

Question: The World Health Organization declared that smallpox was eradicated from the planet in _____. Previously, it was fatal in about ____% of all cases involving infection with Variola major.

a. 1957, 50 b. 1972, 95 c. 1990, 10*d. 1980; 30

Question: Which statement is true of the infectious nature of Francisella tularensis? a. People can be infected by as few as 10 organisms via inhalational b. If by ingestion, it requires a dose of more than a million c. It can be transmitted by flies and ticks*d. All of the above

Question: Two Filoviruses that cause Viral Hemorrhagic Fever are: a. Dengue and Yellow Fever*b. Ebola and Marburg c. Lassa and Junin d. Machupo and Sabia

Essay Question: What is important about Health and Human Services Category A biological agents?  Discuss the attributes that led HHS to place an agent in Category A.  Why is that important and what can it mean to response for public health organizations?

Essay Question: In what ways could plague be used as a biological weapon?

Essay Question: Why would a single case of smallpox be considered an Incident of National Significance, indeed an incident of international significance?

Essay Question: Consider a case of bubonic plague in the Emergency Room of a New York City hospital. Why would this be a “Red Flag” event for Public Health Officials?

Chapter 4Category B Agents and Diseases

Question: Brucella melitensis is one of the etiologic agents of brucellosis. What is the most common means of transmission in humans? a. Breathing in dust particles from livestock yards b. Eating beef jerky or smoked meats*c. Consuming infected unpasteurized milk or dairy products d. Through a break in the skin

Question: What is the etiologic agent of glanders? a. Shigella glanderii*b. Burkholderia mallei c. Burkholderia pseudomallei d. Campylobacter jejuni

Question: Which one of the Category B agents is a Rickettsia? a. Brucella suis b. Burkholderia mallei*c. Coxiella burnetii d. Ricinus communis

Question: What toxic affect makes ricin so poisonous?*a. Irreversibly blocks protein synthesis b. Liquefies internal organs c. Blocks nerve transmission d. Inhibits cytochrome oxidase

Question: Coxiella burnetii is the etiologic agent of what disease?*a. Q Fever b. Anthrax c. Plague d. Glanders

Question: What is the etiologic agent of Psittacosis?*a. Chlamydophila psittaci b. Coxiella burnetii c. Burkholderia mallei d. Brucella suis

Matching Question: Match the agent on the left with the attribute on the right.

Match Question Items Answer ItemsB. - A.  Coxiella burnetii A.  The causative agent of Glanders

 E. - B.  Burkholderia

pseudomallei B.  A spore former

C. - C.  Ricinus communis C.  Can be easily harvested and used to produce a crude toxin

D. - D.  Brucella abortus D.  Causes Bang’s DiseaseA. - E.  Burkholderia mallei E.  The etiologic agent of melioidosis

Question: There have been no human cases of glanders in the United States since 1954.*a. True b. False

Question: Most cases of Q fever are asymptomatic and without clinical consequence.*a. True b. False

Question: Like brucellosis, psittacosis is a zoonotic disease affecting mostly humans and sheep. a. True*b. False

Question: Arbovirus is shortened term for _____________. Answer: ar thropod- bo rne virus

Essay Question: What is important about Health and Human Services Category B biological agents?  Discuss the attributes that led HHS to place an agent in Category B.

Essay Question: In what ways would an intentional outbreak of Q fever overwhelm the medical and public health communities?

Essay Question: What is it about ricin that causes it to be used in so many recent biocrimes?

Essay Question: What makes Category B agents so challenging to public health officials and medical systems?

Chapter 5Category C Agents and Diseases

Question: When and where did West Nile virus make it into the United States? a. Los Angeles, CA; 2001 b. Chicago, IL; 1945 c. Leavenworth, KS; 1918*d. New York, NY; 1999

Question: Which mode(s) of introduction could possibly explain how West Nile virus made it into the United States? CHECK ALL THAT APPLY*a. Infected human host*b. Human transported vector (mosquito)*c. Storm transported vertebrate host (bird) *d. Intentional introduction

Question: What is the cause of SARS?*a. a new Coronavirus b. a Flavivirus c. the influenza virus d. an orthomyxovirus

Question: Where did the SARS virus come from? a. Birds*b. Nobody really knows c. Bats d. Mosquitoes

Question: Which of the diseases shown below was recently added to the list of communicable diseases where federal isolation or quarantine is authorized? a. Nipah fever b. West Nile fever c. Foot and Mouth Disease*d. Severe Acute Respiratory Syndrome (SARS)

Question: Hantavirus is a DNA virus in the orthopoxvirus group. a. True*b. False

Question: Severe Acute Respiratory Syndrome (SARS) appeared as an outbreak in _______ very suddenly in 2003. Answer: China

Question: Which city in North America was most affected by SARS? a. Winnipeg*b. Toronto c. Atlanta

d. New Orleans, LA

Question: The natural cycle of transmission of Nipah virus involves _____________ as reservoirs and ______ as amplifying hosts. a. Squirrels; horses b. White-footed mice; mules*c. Fruit bats; pigs d. Roof rats; humans

Question: The original outbreak of Nipah virus occurred in ___________. a. Bangladesh b. Sri Lanka c. Bali*d. Malaysia

Question: Hantaviruses are categorized as BSL-4 agents when propagating them in culture or passing them through laboratory animals known to be efficient reservoirs.*a. True b. False

Essay Question: What are some of the attributes of a Category C agent that might make them attractive to a potential bioterrorist?

Essay Question: Give a recent example of an emerging disease pathogen that is currently presenting challenges to public health officials. Discuss your community’s level of preparedness for this threat.

Essay Question: Discuss the natural history (ecology) of hantavirus in the United States. In your discussion, identify the reservoir(s) for the disease and the ideal environmental setting for transmission to occur.

Essay Question: Discuss the possibilities for the introduction of West Nile virus into the United States. Which of these possibilities do you believe is actually responsible for its introduction into North America? Defend your position.

Chapter 6 Recognize, Avoid, Isolate and Notify

Question: When it comes to evaluating new diagnostic tests, their accuracy is determined by two parameters. What are they?*a. Sensitivity and Specificity b. Positive and Negative Predictive Values c. Goodness of fit and Kurtosis d. None of the above

Question: Considering the accuracy of any diagnostic test, as a minimum, what two things should be considered?*a. Sensitivity and Specificity compared to a “Gold Standard” b. Ease of use and time to result c. Negative and positive predictive value d. Cost per unit and limit of detection

Question: Inaccurate diagnostic test results can lead to a number of problems. A false negative test result could lead to:*a. a missed diagnosis b. an early treatment c. a good prognosis d. All of the above

Question: In keeping with the last question, a false positive test result could cause: a. a doctor to prescribe medication when it’s not needed b. an Incident Commander to needlessly declare an area a Hot Zone c. a public health officer to wrongly order people into isolation or quarantine*d. All of the above

Question: When it comes to dealing with hazardous materials [e.g., chemical, biological, radiological/nuclear, and explosive (CBRNE)] responders function at various levels. These performance levels and their requisite training are specified in ___________. a. 42 CFR Part 73 and 74*b. 29 CFR – 1910.120. c. 29 CFR – 1910.134 d. All of the above

Question: Culturing is still the gold standard in many environmental testing programs.*a. True b. False

Question: When it comes to Isolation, the Incident Commander needs to move quickly to Isolate the area by establishing ____, ______, and _____ zones.*a. Hot, Warm, Cold b. Primary, Secondary, Tertiary

c. Contaminated, Buffer, Free d. None of the above

Question: Wicking assays can be very practical for the field. Which rapid field test for anthrax recently gained approval from the Department and Homeland Security and the CDC for use by first responders in the field? a. Biowarfare Anthrax Kit, New Horizons Diagnostics b. MIDI Sherlock Microbial Identification System, MIDI, Inc. c. RAMP® Anthrax Test Cartridge, Response Biomedical Corp.*d. There is no such device

Question: The key to avoidance is personal protection and the establishment of protection zones.*a. True b. False

Matching Question: Match the agent on the left with the attribute on the right.

Match Question Items Answer ItemsB. - A.  On scene

incident commander

A.  trained to initiate an emergency response sequence by notifying the proper authorities 

E. - B.  Hazardous materials specialists

B.  assume control of the incident scene

C. - C.  Hazardous materials technicians

C.  will approach the point of release in order to plug, patch or otherwise stop the release of a hazardous substance

D. - D.  First responder operations level

D.  trained to respond in a defensive fashion without actually trying to stop the release

A. - E.  First responder awareness level

E. duties require a more directed or specific knowledge of the substances they may be called upon to contain - also act as the site liaison with Federal, state, local and other government authorities.

Essay Question: What guidance is out there for biological sampling for responders to follow?

Essay Question: What confounding factors might affect the taking of an environmental sample?

Essay Question: A police officer is dispatched to the mall to investigate a complaint about a suspicious package left in the food court. The officer locates the package and observes a fine mist emanating from an orifice in the top of the box. Apply the concept of RAIN to the officer’s situation.

Essay Question: List and/or describe some of the indications of a biological attack.

Chapter 7Case Studies

Question: Which incident or epidemic is known as the largest documented outbreak of human inhalation anthrax? a. The Amerithrax Incident of 2001 b. Gruinard Island Test Program c. Operation Coast, South Africa*d. The 1979 Sverdlovsk Accident

Question: Which Soviet official confirmed our suspicions about the cause of the numerous human and animal cases of anthrax in the Sverdlovsk region? a. Victor Petrenko*b. Boris Yeltsin c. Vladimir Putin d. Ken Alibek

Question: With respect to the inhalation anthrax cases from the Amerithrax incident, the clinical presentation in these 10 patients was variable and often resembled a viral respiratory illness.*a. True b. False

Question: What strain of Bacillus anthracis was recovered from envelopes in the Amerithrax incident?*a. Ames strain b. Sterne strain c. Kensington strain d. USAMRIID strain

Question: Why haven’t we seen more “anthrax letters” since the fall of 2001? a. The perpetrator is in custody b. The perpetrator is dead c. The perpetrator ran out of material*d. No one really knows for sure

Question: Which US Senator’s office was the target of a letter containing ricin? a. Senator Tom Daschle b. Senator Patrick Leahy*c. Senator Bill Frist d. Senator Ted Kennedy

Question: What was one of the main contributing factors to the lack of containment with the 1994 outbreak of pneumonic plague in Surat, India? a. Lack of reporting procedures b. Improper rodent control c. Misdiagnosis and mistreatment

*d. Late initiation of quarantine or cordon sanitaire

Question: What bacterial agent did the Rajneesh cult use against the residents of The Dalles, Oregon? a. Shigella dysenteriae b. Clostridium botulinum c. Vibrio cholerae*d. Salmonella typhimurium

Question: The cult, Aum Shinrikyo, used Bacillus anthracis against the Japanese people. Why was their act of bioterrorism considered to be unsuccessful? a. They disseminated the spores with an explosive device b. They picked the wrong time of day to dispense the material*c. They used a vaccine strain known as Sterne d. The act was successful, killing several hundred people

Question: Who is considered to be the index case of inhalation anthrax in the fall of 2001?*a. Bob Stevens b. Joseph Curseen c. Ottie Lundgren d. Kathy Nguyen

Question: In 1979, an accidental release of Bacillus anthracis spores from a biowarfare production resulted in the death of more than 60 people. Where did this take place? a. Building 568, Fort Detrick*b. Compound 19, Sverdlovsk, Russia c. Dugway Proving Grounds, Utah d. Gruinard Island, Scotland

Essay Question: Does it seem to matter if an outbreak is derived from a natural, accidental or intentional event? In what ways are they equivocal? In what ways are they different?

Essay Question: Would automated biosensor programs increase, decrease or have no effect on the vigilance of medical practitioners presented with unusual disease outbreaks?

Essay Question: How can factors of politics and emotion be minimized during the investigation of an outbreak?

Essay Question: What is cordon sanitaire and how difficult would it be today to implement in a disease outbreak containment program?

Chapter 8Agriculture and the Biological Threat

Question: Which Presidential Directive seeks primarily to protect the food supply from acts of terrorism? a. HSPD10 b. HSPD 5*c. HSPD 9 d. NSP 37

Question: Which of the following diseases were used by the Germans in World War I against the Allied horse and mule population? SELECT ALL THAT ALLPY*a. glanders*b. anthrax c. Foot and Mouth Disease d. Karnal Bunt

Question: According to a recent estimate, agriculture accounts for ___% of the Gross Domestic Product and ____% of all jobs in the United States. a. 8% and 20%, respectively b. 10% and 5%, respectively*c. 13% and 17%, respectively d. 24% and 40%, respectively

Question: Agricultural assets make very lucrative targets. Why? a. Crops and herds are maintained at a high density b. Herd immunity would not protect naturally against many foreign diseases c. They represent our fundamental and material wealth*d. All of the above

Question: What public official was quoted in December 2004 as saying "For the life of me, I cannot understand why the terrorists have not attacked our food supply because it is so easy to do."? a. CDC Director Dr. Julie Gerberding b. President George W. Bush c. Secretary of State Colin Powell*d. Secretary of Health and Human Services Tommy Thompson

Question: What is the causative agent of Rice blast? a. Drosphila melanogaster b. Ralstonia solinaceum c. Mephitis mephitis*d. Magnaporthe grisea

Question: The NPDN reports problems directly to what organization? a. The Centers for Disease Control and Prevention

*b. The National Agricultural Pest Information System (NAPIS) c. The Plant Protection and Quarantine Division d. The Laboratory Response Network Coordinator

Question: The United States is free of Karnal Bunt. a. True*b. False

Question: What agent would be potentially devastating to wheat farmers? a. Drosphila melanogaster b. Ralstonia solinaceum c. Mephitis mephitis*d. Phakopsora pachyrhizi.

Question: Which person would be dispatched to the scene of a suspected Foreign Animal Disease outbreak to take samples and investigate the report? a. PPV*b. FADD c. OIE-T d. NAHEM-PPT

Question: Which Emergency Support Function (ESF) is concerned with response efforts for incidents involving an animal disease, plant disease, or plant pest? a. 6 b. 8*c. 11 d. 13

Essay question: Why would an act of agroterrorism be attractive to a terrorist?

Essay question: What is a CAFO and how does this setting contribute to the spread of an infectious agent?

Essay question: Identify key personnel and officials that would have to be notified and involved whenever a Foreign Animal Disease outbreak is suspected.

Essay question: Discussing the meaning of the term “field to fork” when it comes to biosecurity programs in the agricultural sector.

Chapter 9Foreign Animal Disease Outbreaks and Lessons Learned

Question: What is the causative agent of Foot and Mouth Disease?*a. a picornavirus b. Burkholderia mallei c. aflatoxin d. None of the above

Question: Avian influenza is caused by which type of Influenza virus? a. Type 1*b. Type A c. Type B d. Type 2

Question: Currently, the United States is free of Foot and Mouth Disease.*a. True b. False

Question: Which of the biosecurity control measures shown below could be used in an outbreak of a Foreign Animal Disease in the United States? a. Movement Control b. Quarantine c. Depopulation*d. All of the above

Question: Bovine spongiform encephalopathy has been linked to a variant of Creutzfeldt–Jakob disease (CJD) in humans.*a. True b. False

Question: What is the causative agent of BSE or Mad Cow disease?*a. Prions, which are proteinaceous infectious particles b. a paramyxovirus c. a picornavirus d. the agent is unknown Question: Which poultry disease outbreak in 2003 required NIMS to coordinate the response and recovery efforts? a. Highly Pathogenic Avian Influenza (HPAI)*b. Exotic New Castle disease c. Bordetella avium d. European Fowl Brood

Question: When was the last outbreak of Foot and Mouth disease (FMD) in the United States? a. 1915

*b. 1929 c. 1976 d. 2003

Question: What is the primary means of transmission of FMD virus? a. Feed contaminated with animal parts*b. By respiratory aerosols and contact with infected animals c. Through breaks in the skin d. Fomites

Question: What type of influenza virus causes outbreaks of avian influenza?*a. Type A b. Type B c. TN765 d. Paramyxovirus

Question: Avian influenza virus does not affect humans. a. True*b. False

Question: In August 1997, the FDA instituted regulations to prohibit the use of most mammalian protein, with a few exceptions, in ruminant animal feeds. What is that rule called? a. The Downer Cow Provision*b. The Animal Feed Rule c. Advanced Meat Recovery Ruling d. Specified Risk Materials Law

Essay question: Discuss active measures in place in the US to prevent or preclude Mad Cow disease.

Essay question: Why would local first responders need to become involved in the actions of a Foreign Animal Disease outbreak?

Essay question: Discuss two important lessons learned from the 2001 FMD outbreak in the United Kingdom.

Essay question: Discuss the logistical challenges associated with agricultural response.

Chapter 10Legal Aspects of Biosecurity

Question: Which Presidential Directive is also known as Biodefense for the 21st Century?*a. HSPD10 b. HSPD 5 c. HSPD 21 d. NSP 37

Question: What piece of legislation makes it a felony for anyone in the United States to develop, produce, stockpile, transfer, acquire, retain, or possess any biological agent, toxin, or delivery system for use as a weapon? a. Biodefense for the 21st Century b. The Biological Weapons Consortium of 1953 c. HSPD 1*d. The Biological Weapons Anti-Terrorism Act of 1989

Question: Which official of the Federal Government has statutory responsibility for preventing the introduction, transmission, and spread of communicable diseases from foreign countries into the United States?*a. The Secretary for Health and Human Services b. The Director of the Centers for Disease Control and Prevention c. The Surgeon General d. The Vice President

Question: Which Presidential Directive seeks primarily to protect the food supply from acts of terrorism? a. HSPD 5*b. HSPD 9 c. HSPD 10 d. NSPD 31

Question: What piece of legislation makes it a felony for anyone in the United States to develop, produce, stockpile, transfer, acquire, retain, or possess any biological agent, toxin, or delivery system for use as a weapon? a. Biodefense for the 21st Century b. The Biological Weapons Consortium of 1953 c. HSPD 10*d. The Biological Weapons Anti-Terrorism Act of 1989

Question: Which official of the Federal Government has statutory responsibility for preventing the introduction, transmission, and spread of communicable diseases from foreign countries into the United States?*a. The Secretary for Health and Human Services b. The Director of the Centers for Disease Control and Prevention c. The Surgeon General

d. The Vice President

Question: Which public health strategy seeks to separate people who have a specific infectious illness from those who are healthy and to restrict their movement to stop the spread of that illness?*a. Isolation b. Quarantine c. Disinfection d. Ring vaccination

Question: Which Title of the United States Code defines the term Weapon of Mass Destruction? a. 9*b. 18 c. 22 d. 67

Question: During the Amerithrax incident in Washington, DC, the District public health officer declared a public health emergency. a. True*b. False

Question: Which HSPD is aimed specifically at improving medical countermeasures for WMD? a. 5 b. 11*c. 18 d. 7

Question: Which Public Law, signed by President Bush in 2002 gave us the Select Agent Rule? a. Public Law 188-107*b. Public Law 107-188 c. Public Law 10-21 d. Public Law 1910-120

Essay question: Explain the difference between quarantine and isolation.  Define each word and contrast them based on the individuals that you might put into each method of containment.

Essay question: How may State authorities require persons to undergo medical treatment?

Essay question: A public health officer declares a public health emergency. A governor declares a state of emergency. How do they differ?

Essay question: Explain the term “319 Emergency”. Give an example where one would be appropriate.

Chapter 11State and Local Response

Question: Which Homeland Security Presidential Directive was the impetus for the National Incident Management System?*a. HSPD 5 b. HSPD 9 c. HSPD 10 d. HSPD 1

Question: Area Command and Unified Command are one in the same. a. True*b. False

Question: ASTM International produced a protocol for the sampling of biological agents in the field. This protocol covers all possibilities and should be followed for sampling all suspicious substances. a. True*b. False

Question: What team could potentially deploy to a mass casualty incident and/or outbreak situation to lend medical assistance for a 72-hour period? a. DMORT*b. DMAT c. HMRU d. Answers b and c

Question: Assuming there is an act of bioterrorism in your city and it involves a highly contagious bacterial disease agent disseminated effectively to affect thousands, what Federal asset could you request to assist with the medications needed to treat the disease? a. The Metropolitan Medical Response System*b. The Strategic National Stockpile c. DMAT d. DMORT

Question: The primary objective of disease surveillance is to idenitfy trends in infectious disease and determine the risk of disease transmission so that prevention and control measures can be applied to minimize the burden of illness.*a. True b. False

Question: Which Emergency Support Function (ESF) is concerned with medical systems ? a. 6 b. 11

*c. 8 d. 13

Question: There are five primary functions within the Incident Command System. Select the one below that is NOT a function of ICS. a. Command b. Logistics c. Operations d. Finance and Administration*e. Communications

Question: At the onset of an incident of national significance, who will be the Principal Federal Official? a. The President*b. The Secretary of DHS c. The Vice President d. The Chairman of the Joint Chiefs

Question: What type of respiratory protection is required for responders working at the scene of a suspected biological incident where the type of airborne agent and dissemination method is unknown?*a. SCBA b. PAPR c. APR d. N-95 mask

Question: Which National Guard unit might be called out to assist with a suspected WMD incident? a. BIDS-BAWS Detachment b. NBC Reconnaissance Team*c. CST d. HMRU

Essay question: Discuss the process for decontaminating victims being removed from the site of a suspected biological agent release.

Essay question: Select one of the Category A diseases that is transmissible from person to person. Discuss post-exposure containment measures for that disease assuming that recognition occurs within the medical system.

Essay question: Explain the role of the Department of Homeland Security and the FBI following an act of bioterrorism.

Essay question: Discuss the difference between active and passive surveillance.

Chapter 12Programs and Assets

Question: What is BioWatch? a. A DoD program to detect biological agents on military bases*b. An early warning detection system for aerosolized biological agents c. A sentinel system for the post office d. None of the above

Question: The BioWatch program has samplers in how many cities across the US? a. 272 b. 145 c. 5*d. 31

Question: Where are BioWatch samples tested? a. At USAMRIID b. At a commercial laboratory in New York City*c. In a nearby Laboratory Response Network facility d. At the USDA Lab on Plum Island

Question: Within the Laboratory Response Network, which level provides the most routine diagnostic services and may not possess the most sophisticated technologies?*a. The Sentinel Laboratories b. National Laboratories c. Level 1A d. The Satellite Laboratories

Question: What newly formed organization strives to provide advice to federal departments and agencies on ways to minimize the possibility that knowledge and technologies emanating from vitally important biological research will be misused to threaten public health or national security? a. The Department of Homeland Security Bioterrorism Committee*b. The National Science Advisory Board for Biosecurity (NSABB) c. The Laboratory Response Network d. The National Institutes of Health Lexicon Group

Question: What is a term used to describe biological research with legitimate scientific purpose that may be misused to pose a biologic threat to public health and/or national security? a. Specified Risk Material*b. Dual Use research c. Select Agent Manipulation d. Serendipity

Question: Who has the authority to appoint NSABB members? a. The Director of the CDC

b. The US Surgeon General c. The Director of Homeland Security*d. The Secretary of Health and Human Services

Question: What was originally formed in 1999 with an objective to ensure an effective laboratory response to chemical and biological terrorism? a. The Guardian Program*b. The Laboratory Response Network c. The Biohazard Detection System d. The National Incident Management System

Question: What Federal agency maintains the BioWatch sensors? a. The Center for Domestic Preparedness b. The Department of Defense c. The Centers for Disease Control and Prevention *d. The Environmental Protection Agency

Question: In the Laboratory Response Network, the National Labs serve to perform what function? a. Initial screening of all environmental samples*b. Definitive classification of the agent c. Loaning sensitive equipment to first responders d. Training First Responders to perform assays in the field

Question: In the Laboratory Response Network, the Reference Labs serve to perform what function? a. Definitive Classification of the Agent*b. Confirmatory testing c. Writing and validating protocols d. None of the above

Essay question: How does the comprehensive emergency management model relate to countering the threat of biothreat agents?

Essay question: Discuss some important considerations for getting samples to the LRN.

Essay question: What’s wrong with performing rapid tests in the field for the detection of biothreat pathogens?

Essay question: An act of bioterrorism involving pneumonic plague occurs in your town. Imagine how the situation would unfold: How would it be recognized? What agencies in your local community would respond? What assets at the regional, state and federal level could you call upon to lend assistance?

Chapter 13Consequence Management and a Model Program

Question: In relation to Autonomous Detection Systems, consequence management means what? a. Measuring the accuracy of a test platform*b. Having detailed plans and coordination in place to react definitively to a positive signal c. Establishing a network of communications d. Maintaining and staffing the instruments in place

Question: What technology is the basis for the biosensor in the BDS?*a. Real time polymerase chain reaction (PCR) b. Time Resolved Fluorescence (TRF) c. Immunochromatographic Test (ICT) d. Enzyme-Linked Immunosorbent Assay (ELISA)

Question: Currently, the Biohazard Detection System (BDS) will automatically detect what pathogen?*a. Bacillus anthracis b. Smallpox virus c. Ricin d. None of the above

Question: What are the target genes for Bacillus anthracis detection in the USPS BDS? a. HRF and ETS structural proteins b. 16S ribosomal RNA*c. pag and CapB virulence genes on pX01 and pX02 d. DNA polymerase 1

Question: What is the first action to be taken at a mail sorting facility if a BDS unit were to get a positive test result? a. Transfer the BDS cartridge to a postal inspector b. Decontaminate all personnel*c. Evacuate the building and account for personnel d. Send personnel home to take a shower

Question: What is the limit of detection or sensitivity of the BDS biosensor? a. Less than 1 in 500,000 b. Anthrax only*c. About 100 Bacillus anthracis spores in USPS sample d. More than a million spores

Question: Why must positive test results from an Autonomous Detection System (ADS) for Bacillus anthracis be confirmed by the Laboratory Response Network?

*a. Those systems do not use the same assay as the LRN b. These systems do not pass rigid validations c. The USPS doesn’t have that much confidence in the BDS d. The FDA requires this for the administration of antibiotics

Question: The Biohazard Detection System (BDS) was developed for the United States Postal Service by a consortium of private companies led by Northrop Grumman.*a. True b. False

Question: A three-agent cartridge, which tests for the etiologic agents of anthrax, plague and tularemia, has been developed for the BDS.*a. True b. False

Question: The BDS identified its first true positive while in operation on November 18th, 2007. The result was confirmed by the CDC LRN. a. True*b. False

Question: The Biohazard Detection System: a. Is an Autonomous Detection System b. Was validated by numerous federal agencies c. Was deployed at USPS mail sorting facilities*d. All of the above

Essay question: How do the actions outlined in the BDS CONOPS fall into line with RAIN?

Essay question: What are the benefits and features of having an ADS installed? What are the liabilities?

Essay question: Explain what consequence management means to a biodetection program.

Essay question: Support or refute this statement: The existence of the BDS is one of the primary reasons why we haven’t had a repeat of Amerithrax in the United States.

Chapter 14Future Directions for Biosecurity

Question: What book inspired President Bill Clinton to look more deeply into the bioterrorist threat and subsequently issue two Presidential Directives to address national security deficiencies related to biological and chemical terrorism and warfare? a. The Coming Plague by Laurie Garrett *b. The Cobra Event by Richard Preston c. Germs: Biological Weapons and America’s Secret War by Miller, Engelberg and Broad d. Biohazard by Ken Alibek

Question: What is biosecurity? a. Measures to protect from infection. b. Precautions to minimize risk of introducing an infectious agent into a population. c. Policies and measures to protect food supply and agricultural resources from contamination and attacks of bioterrorism*d. All of the above

Question: What former Soviet bioweapons expert discussed “Superbugs” in an interview with NOVA?*a. Sergei Popov b. Alexander Lutvynenko c. Lyudmila Karina d. Viktor Petrenko Question: Which secret group of scientists was formed in 1960 to advise senior officials and help them find solutions to particularly difficult technical problems, mostly having to do with defense? a. Defense Threat Reduction Agency*b. The JASON Group c. Beta Force d. CELL

Essay question: What is the most likely reason for biosecurity programs to increase in scope and complexity over the next ten years?

Essay question: In your opinion, is a major act of bioterrorism likely in the next ten years? If not, what will that do to existing research programs and surveillance systems like BioWatch?

Essay question: Imagine that bioweapons programs come back into prominence and there is a renewed interest in creating “Superbugs” in sophisticated state-sponsored programs.

Essay question: Discuss NIH biodefense research objectives.

Essay question: Discuss ways in which scientific advances might be used to create more lethal and formidable biological weapons.