CIPHI BOC Exam UPDATED QUESTIONS
AND CORRECT ANSWERS
Hepatitis A - Incubation period - CORRECT ANSWER 15-50 days
Usually 28-30 days
Hepatitis A - Symptoms - CORRECT ANSWER loss of appetite, fatigue, nausea,
vomiting, abdominal pain, fever, malaise and yellow skin (jaundice)
Hepatitis A - transmission - CORRECT ANSWER fecal-oral route
Infective: up to 2 weeks before onset to 1 week post-jaundice.
Humans are reservoir.
Hepatitis A - suspect foods - CORRECT ANSWER Ice, shellfish contaminated with
sewage.
Hepatitis A - exclusion criteria - CORRECT ANSWER 14 days if no jaundice. 7 days
after jaundice onset.
Life-long immunity following recovery.
Last 2 - 6 months.
Norovirus - incubation period - CORRECT ANSWER 24-48 hours
Norovirus - symptoms - CORRECT ANSWER Sudden onset, watery diarrhea,
vomiting, cramp, nausea, low fever.
Norovirus - transmission - CORRECT ANSWER Very contagious. Low infective dose.
Fecal-oral. Person-Person. Humans only reservoir.
Norovirus - most at risk - CORRECT 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 - CORRECT ANSWER S. enteritis
S. typhimurium
Salmonellosis incubation - CORRECT ANSWER 6-72 hours
Usually 12-36 hours
Salmonellosis symptoms - CORRECT ANSWER Sudden onset, cramp, diarrhea,
nausea, headache, possible vomit.
Salmonellosis transmission - CORRECT ANSWER Bacterial. Usually contaminated
food, raw bean sprouts. Human and animal reservoir. Pet contact.
Salmonellosis suspect foods - CORRECT ANSWER Raw egg, unpasteurized milk,
unwashed fruit/veg. Raw meat.
Shigellosis IP - CORRECT ANSWER 12-96 hours (usually 1-3 days)
Shigellosis symptoms - CORRECT ANSWER Diarrhea, fever, cramp. Nausea.
Possible bloody diarrhea.
May cause HUS in kids.
Shigellosis transmission - CORRECT ANSWER Bacterial. Fecal-oral. Sexual contact
Humans only reservoir.
Possibly via mechanical vectors (flies, cockroaches)
Low infectious dose.
,Shigellosis suspect foods - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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. - CORRECT
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.
Raw meat rarely associated with OB b/c poor competitor. - CORRECT
ANSWER Staphylococcus
S. aureus
IP - 1-10 days (usually 2-5 days)
Symptoms - Sudden onset cramp, fever, nausea and/or vomit, possible bloody diarrhea,
greenish stool. (Appendicitis like)
Transmission - Bacterial.
Microaerophilic - grows in gut, not at room temperature.
Fecal-oral. Water/food.
Most raw poultry contamination.
Suspect foods - Contaminated food, water, raw poultry, contact with infected animals. Non-
chlorinated water. - CORRECT ANSWER Campylobacter enteritis
C. jejuni
C. coli
IP - 3-7 days
Symptoms - Cramp, fever, headache, diarrhea, vomiting, nausea, lower right quadrant pain
Transmission - Bacterial. Psychrotroph.
High infectious dose. Animals (pigs) are the main reservoir.
Fecal-oral.
AND CORRECT ANSWERS
Hepatitis A - Incubation period - CORRECT ANSWER 15-50 days
Usually 28-30 days
Hepatitis A - Symptoms - CORRECT ANSWER loss of appetite, fatigue, nausea,
vomiting, abdominal pain, fever, malaise and yellow skin (jaundice)
Hepatitis A - transmission - CORRECT ANSWER fecal-oral route
Infective: up to 2 weeks before onset to 1 week post-jaundice.
Humans are reservoir.
Hepatitis A - suspect foods - CORRECT ANSWER Ice, shellfish contaminated with
sewage.
Hepatitis A - exclusion criteria - CORRECT ANSWER 14 days if no jaundice. 7 days
after jaundice onset.
Life-long immunity following recovery.
Last 2 - 6 months.
Norovirus - incubation period - CORRECT ANSWER 24-48 hours
Norovirus - symptoms - CORRECT ANSWER Sudden onset, watery diarrhea,
vomiting, cramp, nausea, low fever.
Norovirus - transmission - CORRECT ANSWER Very contagious. Low infective dose.
Fecal-oral. Person-Person. Humans only reservoir.
Norovirus - most at risk - CORRECT 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 - CORRECT ANSWER S. enteritis
S. typhimurium
Salmonellosis incubation - CORRECT ANSWER 6-72 hours
Usually 12-36 hours
Salmonellosis symptoms - CORRECT ANSWER Sudden onset, cramp, diarrhea,
nausea, headache, possible vomit.
Salmonellosis transmission - CORRECT ANSWER Bacterial. Usually contaminated
food, raw bean sprouts. Human and animal reservoir. Pet contact.
Salmonellosis suspect foods - CORRECT ANSWER Raw egg, unpasteurized milk,
unwashed fruit/veg. Raw meat.
Shigellosis IP - CORRECT ANSWER 12-96 hours (usually 1-3 days)
Shigellosis symptoms - CORRECT ANSWER Diarrhea, fever, cramp. Nausea.
Possible bloody diarrhea.
May cause HUS in kids.
Shigellosis transmission - CORRECT ANSWER Bacterial. Fecal-oral. Sexual contact
Humans only reservoir.
Possibly via mechanical vectors (flies, cockroaches)
Low infectious dose.
,Shigellosis suspect foods - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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. - CORRECT
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.
Raw meat rarely associated with OB b/c poor competitor. - CORRECT
ANSWER Staphylococcus
S. aureus
IP - 1-10 days (usually 2-5 days)
Symptoms - Sudden onset cramp, fever, nausea and/or vomit, possible bloody diarrhea,
greenish stool. (Appendicitis like)
Transmission - Bacterial.
Microaerophilic - grows in gut, not at room temperature.
Fecal-oral. Water/food.
Most raw poultry contamination.
Suspect foods - Contaminated food, water, raw poultry, contact with infected animals. Non-
chlorinated water. - CORRECT ANSWER Campylobacter enteritis
C. jejuni
C. coli
IP - 3-7 days
Symptoms - Cramp, fever, headache, diarrhea, vomiting, nausea, lower right quadrant pain
Transmission - Bacterial. Psychrotroph.
High infectious dose. Animals (pigs) are the main reservoir.
Fecal-oral.
