Lagarteja, Regrine B.

MICRO 201 Exam Intro to Public Health Microbiology and Enteric Infections

I. Introduction to Public Health Microbiology. In the Philippines, 1. What are the top 10 leading causes of death (mortality) among all of the population? Table 1: Top 10 Leading Causes of Death in the Philippines, 2011 Rank 1 2 3 4 5 6 7 8 9 10 Disease Coronary Heart Disease Influenza & Pneumonia Stroke Tuberculosis Hypertension Diabetes Mellitus Violence Lung Disease Kidney Disease Asthma No. Deaths 57,864 46,900 40,245 35,867 35,001 18,512 17,152 13,473 12,960 10,471 % 13.73 11.13 9.55 8.51 8.30 4.39 4.07 3.20 3.07 2.48 World Rank 79 48 106 34 15 89 40 76 59 24

Source: http://www.worldlifeexpectancy.com/country-health-profile/philippines (Retrieved 18 July 2013)

2. What are the top 10 leading causes of sickness (morbidity) among all of the population?

Source: http://www.gmanetwork.com/news/story/165269/news/nation/poverty-makes-filipinos-more-vulnerableto-flu (retrieved 18 July 2013)

3. What are the top 10 leading causes of mortality among children? Table 3: Top 10 Leading Causes of Death in the Philippines, 2011 1 2 CAUSE Congenital anomalies Injuries No. of Deaths 6892.82 5202.77

3 4 5 6 7 8 9 10

Sepsis and other infectious conditions of the newborn Diarrhoeal diseases Meningitis/encephalitis Other noncommunicable diseases Pertussis Malaria HIV/AIDS Measles

4193.36 3843.56 1727.55 706.43 48.5 41.62 33 31.44

Source: http://apps.who.int/gho/athena/data/download.xsl? format=xml&target=GHO/GBD_0000000036&profile=excel&filter=GBDCHILDCAUSES:*;COUNTRY:PHL (Retrieved 18 July 2013)

4. What are the top 10 leading causes of morbidity among children? Top 10 Leading Causes of Morbidity Among Children, 2008

Source: http://www.hero.org.ph/?p=reco (Retrieved 18 July 2013)

5. What was the Philippines' 2012 budget on health? What is the proposed budget for 2013? The health budget for the year of 2013 is 56.8B out of the 2.066T budget signed by the president. It is 8% larger than the 2012 health budget (which was at 45.8M), according to Department of Budget and Management. It was also reported that the departments of health, social welfare and public works will get the biggest increase in the proposed P2.268-trillion budget for 2014. As mandated by our Constitution, the highest budget allocation is earmarked for the Department of Education (DepEd) at P232.595 billion, and will fully address the shortages in classrooms, teachers and textbooks to support the K+12 program. In particular, the education budget aims to reduce the classroom gap to zero in 2013 by allocating P25.2

billion for the Basic Educational Facilities Fund and P1 billion for the Regular School building Program. In addition, the creation of 61,510 Teaching Positions amounting to P14.538 billion is expected to fully cover the shortfall in teachers this year. Another P1.5 billion is provided for the procurement of 31.1 million textbooks and teachers' manual to maintain a 1:1 ratio of textbooks to students. Although an increase was given to the health budget and is included in the top department priorities according to General Appropriations Act, it is still falls short of the recommended health budget of the World Health Organization (WHO). The health budget for 2013 is just 1.89% of the Gross Domestic Product, very far from the 5% of GDP as recommended by the WHO.

Source: http://budgetngbayan.com/summary-of-allocations/#sector http://newsinfo.inquirer.net/444003/health-social-welfare-public-works-get-biggest-budgethike#ixzz2ZFfLEOCX

6. How will the Health Budget be spent/distributed (eg. personnel, hospitals, medicine)? Sector/ Program Office of the Secretary Commision on Population Local Nutrition Council Allocated Fund 39.5 B 304.5 M 327 M

Health Facility Enhancement Program Specialty Hospitals Institute for Traditional Medicine and Alternative Health Care Health Insurance Program Doctor to the Barrios and Rural Health Practice Program National Pharmaceutical Policy Development Expanded Program on Immunization Priority Programs of Kalusugan Pangkalahatan* Priority Programs of Kalusugan Pangkalahatan: the National Health Insurance Program

13.5 B 908 M 40 M 12.6 B 2.8 B 1B 1.9 B 69% of 2013 Budget

1. Subsidy for Health Insurance Premium payment of indigent families to 2. Health Facilities Enhancement Program 3. Implementation of the Doctors to the Barrios and Rural Health Practice Program 4. Family Health including Responsible Parenting 5. Expanded Program on Immunization 6. National Pharmaceutical Policy Development including provision of drugs and medicines, medical and dental supplies to make affordable quality drugs available 7. Tuberculosis Control 8. Elimination of diseases as public health threats such as malaria, schistosomiasis, leprosy and filariasis 9. Other infectious diseases and emerging diseases including HIV/AIDS, dengue, food and water-borne diseases 10. Rabies Control Program

Source: http://www.doh.gov.ph/content/doh-2013-budget-promises-better-health-all-filipinos.html

II. Enterics. Download the lecture from the internet and answer the multiple choice questions, write the letter of your answer, then explain briefly your chosen answer. Submit by Friday, July 19, 12 noon. Submit a hard copy, in Arial size 12 font, 1.5 spacing, using recycled paper. You may place your take home exam inside recycled envelope, place the envelope in my pigeon hole at the Department of Medical Microbiology. Multiple Choice: C 1. One of the most important factors in controlling foodborne and waterborne disease is to A. isolate infected persons because person-to-person transmission is so easy. B. educate people in proper methods of sanitation and personal hygiene. C. control animal pests that may transfer the organisms into the water supply. D. inoculate as many people as possible against the diseases in order to control epidemics. Controlling the pests reduce transfer of foodborne and waterborne diseases by preventing them to transfer the organisms that they carry to our food and drink. Isolation of infected person is not necessary because the common mode of transmission of enteric diseases are via the oral-fecal route. Inoculation of many people can result to epidemics or pandemics.

A 2. Salmonella and the disease Salmonellosis is best described by which statement? A. Hundreds of serotypes of Salmonella cause the disease. B. Symptoms include diarrhea almost as severe as that of cholera. C. It is identical to dysentery caused by members of the genus Shigella. D. The infective dose is small, only a few hundred organisms. About 200 serotypes of Salmonella causes diarrhea. Diarrhea is a common symptom of enteric disease, regardless of the cause.

B 3. Among the principal causes of traveler's diarrhea is/are A. multiple serotypes of Salmonella. B. Escherichia coli. C. staphylococci and streptococci. D. Vibrio cholerae Almost 25-75% of the travelers diarrhea accounts to Escherichia coli infection.

D 4. All the following bacteria are recognized as causes of foodborne or waterborne infections except A. Bacillus cereus. B. Yersinia enterocolitica. C. Vibrio parahaemolyticus. D. Yersinia pestis. Yersinia pestis causes plague (pneumonic, septicemic, and bubonic) and is transferred via vectors like rat fleas. It attacks the lymphatic system.

C 5. The folllowing organisms spoil food EXCEPT: A. bacteria B. moulds its host C. virus D. yeast Viruses cannot spoil food because they are not free-living, ergo, they cannot grow outside of

E 6. Lactic acid producing bacteria are found in: A. animal intestines B. human intestine the above C. plants D. soil E. all of

B 7. Lactic acid bacteria : A. ferments lactose sugar B. lowers pH of food C. both A and B are correct D. both A and B are wrong

Lactic acid bacteria produce lactic acid as a major end product of carbohydrate fermentation. It lowers the pH of food to prevent it from spoilage.

D 8. In 1854, John Snow determined that the source of the cholera causing an epidemic was A. contaminated food in the shops. B. contaminated straw used to line the streets. C. cloth imported from India. D. a pump handle for a well. In 1854, a cholera outbreak attacked the Broad Street in London. People suffer from diarrhea and some die of dehydration. John Snow, a physician, investigated the cause of the said

outbreak. He then plotted the cases of cholera in a map and found out that the people near the Broad Street had the most cases of cholera. Upon investigation, he concluded that the water pump in the said area might have caused the outbreak. To prevent the increase of the number of cases, he removed the pump handle so that people will no longer take water on the said pump.

B 9. Fish and shellfish food sources may harbor the following microorganisms, EXCEPT: A. bacteria B. fungi C. parasites D. viruses

No known fungi can infect fishes and shellfishes because the mucus produced by their skin prevents them from being infected by the fungi. Infection of these organisms is only possible if the mucus production is stopped.

C 10. The following food raw materials will least likely harbor microbes: A. animal meats B. fats and oils C. spices D. vegetables E. water

Spices like cinnamon and garlic were proven to kill bacteria. A study conducted at the Kansas State University showed that cloves kill E.coli.