CIPHI BOC STUDY EXAM UPDATED
QUESTIONS AND CORRECT ANSWERS.
Hepatitis A - Incubation period - ANS 15-50 days
Usually 28-30 days
Hepatitis A - Symptoms - ANS loss of appetite, fatigue, nausea, vomiting, abdominal pain,
fever, malaise and yellow skin (jaundice)
Hepatitis A - transmission - ANS fecal-oral route
Infective: up to 2 weeks before onset to 1 week post-jaundice.
Humans are reservoir.
Hepatitis A - suspect foods - ANS Ice, shellfish contaminated with sewage.
Hepatitis A - exclusion criteria - ANS 14 days if no jaundice. 7 days after jaundice onset.
Life-long immunity following recovery.
Last 2 - 6 months.
Norovirus - incubation period - ANS 24-48 hours
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,Norovirus - symptoms - ANS Sudden onset, watery diarrhea, vomiting, cramp, nausea, low
fever.
Norovirus - transmission - ANS Very contagious. Low infective dose. Fecal-oral. Person-
Person. Humans only reservoir.
Norovirus - most at risk - ANS 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 - ANS S. enteritis
S. typhimurium
Salmonellosis incubation - ANS 6-72 hours
Usually 12-36 hours
Salmonellosis symptoms - ANS Sudden onset, cramp, diarrhea, nausea, headache, possible
vomit.
Salmonellosis transmission - ANS Bacterial. Usually contaminated food, raw bean sprouts.
Human and animal reservoir. Pet contact.
Salmonellosis suspect foods - ANS Raw egg, unpasteurized milk, unwashed fruit/veg. Raw
meat.
Shigellosis IP - ANS 12-96 hours (usually 1-3 days)
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,Shigellosis symptoms - ANS Diarrhea, fever, cramp. Nausea.
Possible bloody diarrhea.
May cause HUS in kids.
Shigellosis transmission - ANS Bacterial. Fecal-oral. Sexual contact
Humans only reservoir.
Possibly via mechanical vectors (flies, cockroaches)
Low infectious dose.
Shigellosis suspect foods - ANS 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 - ANS 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 - ANS Bacillus Cereus (emetic)
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, 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 - ANS 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. - ANS 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. - ANS 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. - ANS Campylobacter enteritis
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QUESTIONS AND CORRECT ANSWERS.
Hepatitis A - Incubation period - ANS 15-50 days
Usually 28-30 days
Hepatitis A - Symptoms - ANS loss of appetite, fatigue, nausea, vomiting, abdominal pain,
fever, malaise and yellow skin (jaundice)
Hepatitis A - transmission - ANS fecal-oral route
Infective: up to 2 weeks before onset to 1 week post-jaundice.
Humans are reservoir.
Hepatitis A - suspect foods - ANS Ice, shellfish contaminated with sewage.
Hepatitis A - exclusion criteria - ANS 14 days if no jaundice. 7 days after jaundice onset.
Life-long immunity following recovery.
Last 2 - 6 months.
Norovirus - incubation period - ANS 24-48 hours
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,Norovirus - symptoms - ANS Sudden onset, watery diarrhea, vomiting, cramp, nausea, low
fever.
Norovirus - transmission - ANS Very contagious. Low infective dose. Fecal-oral. Person-
Person. Humans only reservoir.
Norovirus - most at risk - ANS 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 - ANS S. enteritis
S. typhimurium
Salmonellosis incubation - ANS 6-72 hours
Usually 12-36 hours
Salmonellosis symptoms - ANS Sudden onset, cramp, diarrhea, nausea, headache, possible
vomit.
Salmonellosis transmission - ANS Bacterial. Usually contaminated food, raw bean sprouts.
Human and animal reservoir. Pet contact.
Salmonellosis suspect foods - ANS Raw egg, unpasteurized milk, unwashed fruit/veg. Raw
meat.
Shigellosis IP - ANS 12-96 hours (usually 1-3 days)
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,Shigellosis symptoms - ANS Diarrhea, fever, cramp. Nausea.
Possible bloody diarrhea.
May cause HUS in kids.
Shigellosis transmission - ANS Bacterial. Fecal-oral. Sexual contact
Humans only reservoir.
Possibly via mechanical vectors (flies, cockroaches)
Low infectious dose.
Shigellosis suspect foods - ANS 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 - ANS 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 - ANS Bacillus Cereus (emetic)
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, 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 - ANS 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. - ANS 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. - ANS 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. - ANS Campylobacter enteritis
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