CIPHI BOC STUDY QUESTIONS WITH COMPLETE SOLUTIONS
Hepatitis A - Incubation period - ANSWER-15-50 days
Usually 28-30 days
Hepatitis A - Symptoms - ANSWER-loss of appetite, fatigue, nausea, vomiting,
abdominal pain, fever, malaise and yellow skin (jaundice)
Hepatitis A - transmission - ANSWER-fecal-oral route
Infective: up to 2 weeks before onset to 1 week post-jaundice.
Humans are reservoir.
Hepatitis A - suspect foods - ANSWER-Ice, shellfish contaminated with sewage.
Hepatitis A - exclusion criteria - ANSWER-14 days if no jaundice. 7 days after
jaundice onset.
Life-long immunity following recovery.
Last 2 - 6 months.
Norovirus - incubation period - ANSWER-24-48 hours
Norovirus - symptoms - ANSWER-Sudden onset, watery diarrhea, vomiting,
cramp, nausea, low fever.
,Norovirus - transmission - ANSWER-Very contagious. Low infective dose. Fecal-
oral. Person-Person. Humans only reservoir.
Norovirus - most at risk - ANSWER-o Children
o Older Adults
o Those with weakened immune systems.
o These higher risk groups are more likely to experience dehydration as a result
of severe vomiting and diarrhea
Salmonellosis types - ANSWER-S. enteritis
S. typhimurium
Salmonellosis incubation - ANSWER-6-72 hours
Usually 12-36 hours
Salmonellosis symptoms - ANSWER-Sudden onset, cramp, diarrhea, nausea,
headache, possible vomit.
Salmonellosis transmission - ANSWER-Bacterial. Usually contaminated food, raw
bean sprouts. Human and animal reservoir. Pet contact.
Salmonellosis suspect foods - ANSWER-Raw egg, unpasteurized milk, unwashed
fruit/veg. Raw meat.
Shigellosis IP - ANSWER-12-96 hours (usually 1-3 days)
,Shigellosis symptoms - ANSWER-Diarrhea, fever, cramp. Nausea.
Possible bloody diarrhea.
May cause HUS in kids.
Shigellosis transmission - ANSWER-Bacterial. Fecal-oral. Sexual contact
Humans only reservoir.
Possibly via mechanical vectors (flies, cockroaches)
Low infectious dose.
Shigellosis suspect foods - ANSWER-Shigella is not naturally present on foods,
but can contaminate food through cross contamination during handling, or from
exposure to polluted water
Food is most often contaminated with Shigella from water polluted by human
sewage.
IP - 1-90 days (usually 3-70 days)
Symptoms - Most cases asymptomatic. Fever, headache. <5% vomit & diarrhea.
Transmission: Environmental bacteria. Gets in raw product (between cooking &
packaging) & spreads via cross-contamination.
** Psychrotroph. Hardy.
Suspect Foods: Soft cheeses, deli meats, hot dogs, ready to eat meats,
unpasteurized milk.
Concern for pregnant women - ANSWER-Listeriosis
L. monocytogenes
, IP - 0.5-6 hours
Symptoms - Nausea, vomiting, rarely fever and diarrhea
Transmission - Bacterial. Grows and produces heat stable enterotoxin in food.
Suspect foods - Cooked rice left at room temperature - ANSWER-Bacillus Cereus
(emetic)
IP - 4-96 hours (usually 12-24)
Symptoms - Severe cramp, watery diarrhea, nausea, vomiting, headache, fever.
Transmission - Bacterial. Marine organism. More wound infections than FBI.
Suspect foods - raw shellfish - ANSWER-Vibrio parahemolyticus
IP - 6-24 hours
Symptoms - Cramp, diarrhea, nausea, rarely vomit and fever.
Transmission - Bacterial. Grows and produces heat labile enterotoxin in food.
Suspect foods - Meat and vegetable soups, cooked meat, desserts, starches. -
ANSWER-Bacillus Cereus (diarrheal)
IP - 0.5 - 8 hours (usually 2-4 hours)
Symptoms - Vomiting, cramp, diarrhea, nausea.
Transmission - Bacterial. Humans main reservoir. Carried in nares.
Produces heat stable enterotoxin as grows in food.
Suspect foods - Pork, ham, custard, cream desserts.
Hepatitis A - Incubation period - ANSWER-15-50 days
Usually 28-30 days
Hepatitis A - Symptoms - ANSWER-loss of appetite, fatigue, nausea, vomiting,
abdominal pain, fever, malaise and yellow skin (jaundice)
Hepatitis A - transmission - ANSWER-fecal-oral route
Infective: up to 2 weeks before onset to 1 week post-jaundice.
Humans are reservoir.
Hepatitis A - suspect foods - ANSWER-Ice, shellfish contaminated with sewage.
Hepatitis A - exclusion criteria - ANSWER-14 days if no jaundice. 7 days after
jaundice onset.
Life-long immunity following recovery.
Last 2 - 6 months.
Norovirus - incubation period - ANSWER-24-48 hours
Norovirus - symptoms - ANSWER-Sudden onset, watery diarrhea, vomiting,
cramp, nausea, low fever.
,Norovirus - transmission - ANSWER-Very contagious. Low infective dose. Fecal-
oral. Person-Person. Humans only reservoir.
Norovirus - most at risk - ANSWER-o Children
o Older Adults
o Those with weakened immune systems.
o These higher risk groups are more likely to experience dehydration as a result
of severe vomiting and diarrhea
Salmonellosis types - ANSWER-S. enteritis
S. typhimurium
Salmonellosis incubation - ANSWER-6-72 hours
Usually 12-36 hours
Salmonellosis symptoms - ANSWER-Sudden onset, cramp, diarrhea, nausea,
headache, possible vomit.
Salmonellosis transmission - ANSWER-Bacterial. Usually contaminated food, raw
bean sprouts. Human and animal reservoir. Pet contact.
Salmonellosis suspect foods - ANSWER-Raw egg, unpasteurized milk, unwashed
fruit/veg. Raw meat.
Shigellosis IP - ANSWER-12-96 hours (usually 1-3 days)
,Shigellosis symptoms - ANSWER-Diarrhea, fever, cramp. Nausea.
Possible bloody diarrhea.
May cause HUS in kids.
Shigellosis transmission - ANSWER-Bacterial. Fecal-oral. Sexual contact
Humans only reservoir.
Possibly via mechanical vectors (flies, cockroaches)
Low infectious dose.
Shigellosis suspect foods - ANSWER-Shigella is not naturally present on foods,
but can contaminate food through cross contamination during handling, or from
exposure to polluted water
Food is most often contaminated with Shigella from water polluted by human
sewage.
IP - 1-90 days (usually 3-70 days)
Symptoms - Most cases asymptomatic. Fever, headache. <5% vomit & diarrhea.
Transmission: Environmental bacteria. Gets in raw product (between cooking &
packaging) & spreads via cross-contamination.
** Psychrotroph. Hardy.
Suspect Foods: Soft cheeses, deli meats, hot dogs, ready to eat meats,
unpasteurized milk.
Concern for pregnant women - ANSWER-Listeriosis
L. monocytogenes
, IP - 0.5-6 hours
Symptoms - Nausea, vomiting, rarely fever and diarrhea
Transmission - Bacterial. Grows and produces heat stable enterotoxin in food.
Suspect foods - Cooked rice left at room temperature - ANSWER-Bacillus Cereus
(emetic)
IP - 4-96 hours (usually 12-24)
Symptoms - Severe cramp, watery diarrhea, nausea, vomiting, headache, fever.
Transmission - Bacterial. Marine organism. More wound infections than FBI.
Suspect foods - raw shellfish - ANSWER-Vibrio parahemolyticus
IP - 6-24 hours
Symptoms - Cramp, diarrhea, nausea, rarely vomit and fever.
Transmission - Bacterial. Grows and produces heat labile enterotoxin in food.
Suspect foods - Meat and vegetable soups, cooked meat, desserts, starches. -
ANSWER-Bacillus Cereus (diarrheal)
IP - 0.5 - 8 hours (usually 2-4 hours)
Symptoms - Vomiting, cramp, diarrhea, nausea.
Transmission - Bacterial. Humans main reservoir. Carried in nares.
Produces heat stable enterotoxin as grows in food.
Suspect foods - Pork, ham, custard, cream desserts.
