Lesson 5: Public Health Surveillance

Self-Assessment Quiz

Now that you have read Lesson 5 and have completed the exercises, you should be ready to take the self-assessment quiz. This quiz is designed to help you assess how well you have learned the content of this lesson. You may refer to the lesson text whenever you are unsure of the answer.

Unless instructed otherwise, choose ALL correct answers for each question.

1. As described in this lesson, public health surveillance includes which activities?
   1. Data collection.
   2. Data analysis.
   3. Data interpretation.
   4. Data dissemination.
   5. Disease control.
2. Current public health surveillance targets which of the following?
   1. Chronic diseases.
   2. Communicable diseases.
   3. Health-related behaviors.
   4. Occupational hazards.
   5. Presence of viruses in mosquitoes.
3. Public health surveillance can be described primarily as which of the following?
   1. A method to monitor occurrences of public health problems.
   2. A program to control disease outbreaks.
   3. A system for collecting health-related information.
   4. A system for monitoring persons who have been exposed to a communicable disease.
4. Public health surveillance is only conducted by public health agencies.
   1. True.
   2. False.
5. Common uses and applications of public health surveillance include which of the following?
   1. Detecting individual persons with malaria so that they can receive prompt and appropriate treatment.
   2. Helping public health officials decide how to allocate their disease control resources.
   3. Identifying changes over time in the proportion of children with elevated blood lead levels in a community.
   4. Documenting changes in the incidence of varicella (chickenpox), if any, after a law requiring varicella vaccination took effect.
6. Data collected through which of the following methods is commonly used for surveillance?
   1. Vital registration.
   2. Randomized clinical trials.
   3. Disease notifications.
   4. Population surveys.
7. Health-care providers might be important sources of surveillance data used by public health officials, and they should receive feedback to close the surveillance loop as a courtesy; however, the results almost never have any relevance to patient care provided by those health-care providers.
   1. True.
   2. False.
8. Vital statistics are important sources of data on which of the following?
   1. Morbidity.
   2. Mortality.
   3. Health-related behaviors.
   4. Injury and disability.
   5. Outpatient health-care usage.
9. Vital statistics provide an archive of certain health data. These data do not become surveillance data until they are analyzed, interpreted, and disseminated with the intent of influencing public health decision-making or action.
   1. True.
   2. False.
10. Key sources of morbidity data include which of the following?
    1. Environmental monitoring data.
    2. Hospital discharge data.
    3. Laboratory results.
    4. Notifiable disease reports.
    5. Vital records.
11. Notifiable disease surveillance usually focuses on morbidity from the diseases on the list and does not cover mortality from those diseases.
    1. True.
    2. False.
12. The list of diseases that a physician must report to the local health department is typically compiled by the…
    1. Local health department.
    2. State health department.
    3. Centers for Disease Control and Prevention (CDC).
    4. Council of State and Territorial Epidemiologists (CSTE).
    5. Medical licensing board.
13. A physician working in an emergency room in Town A, USA, has just examined a tourist from Southeast Asia with watery diarrhea. The physician suspects the man might have cholera. The physician should notify the …
    1. Local (town or county) health agency.
    2. State health department.
    3. Centers for Disease Control and Prevention (CDC).
    4. U.S. Department of State.
    5. Washington, D.C., embassy of country of origin (ask for health attaché).
14. Use the following choices for Questions 14a–e.
    1. Notifiable disease surveillance
    2. Surveillance for consumer product-related injuries
    3. Both.
    4. Neither.
    1. ____ State-based, with subsequent reporting to CDC.
    2. ____ Focused on identifying individual cases.
    3. ____ Can monitor trends over time.
    4. ____ Based on statistically valid sample.
    5. ____ Complete, unbiased reporting.
15. Evaluating and improving surveillance should address which of the following?
    1. Purpose and objectives of surveillance.
    2. Resources needed to conduct surveillance.
    3. Effectiveness of measures for controlling the disease under surveillance.
    4. Presence of characteristics of well-conducted surveillance.
16. Criteria for prioritizing health problems for surveillance include which of the following?
    1. Incidence of the problem.
    2. Public concern about the problem.
    3. Number of previous studies of the problem.
    4. Social and economic impact of the problem.
17. Use the following choices for Questions 17a–d.
    1. Surveillance based on a specific case definition for a disease (e.g., listeriosis).
    2. Syndromic surveillance based on symptoms, signs, or other characteristics of a disease, rather than specific clinical or laboratory diagnostic criteria.
    3. Both.
    4. Neither.
    1. ____ Watches for individual cases of disease of public health importance.
    2. ____ Watches for diseases that might be caused by acts of biologic or chemical terrorism.
    3. ____ Can watch for disease before a patient seeks care from a health-care provider.
    4. ____ Requires little effort on the part of the health department.
18. Routine analysis of notifiable disease surveillance data at the state health department might include looking at the number of cases of a disease reported this week …
    1. and during the previous 2–4 weeks.
    2. and the number reported during the comparable weeks of the previous 2–5 years.
    3. simultaneously by age, race, and sex of the patient.
    4. by county.
    5. by county, divided by each county's population (i.e., county rates).
19. One week, a state health department received substantially more case reports of a disease in one county than had been reported during the previous 2 weeks. No increase was reported in neighboring counties. Possible explanations for this increase include which of the following?
    1. An outbreak in the county.
    2. Batch reports.
    3. Duplicate reports.
    4. Increase in the county's population.
    5. Laboratory error.
20. The primary reason for preparing and distributing periodic surveillance summaries is which of the following?
    1. Document recent epidemiologic investigations.
    2. Provide timely information on disease patterns and trends to those who need to know it.
    3. Provide reprints ofMMWR articles, reports, and recommendations.
    4. Acknowledge the contributions of those who submitted case reports.
21. Use the following choices for Questions 21a–b.
    1. Predictive value positive.
    2. Sensitivity.
    3. Specificity.
    4. Validity.
    1. ____ Surveillance detected 23 of 30 actual cases of a disease.
    2. ____ Of 16 statistically significant aberrations (deviations from baseline) detected by syndromic surveillance, only one represented an actual outbreak of disease.
22. Underreporting is not a problem for detecting outbreaks of notifiable diseases because the proportion of cases reported tends to remain relatively stable over time.
    1. True.
    2. False.
23. Initiating surveillance for a public health problem or adding a disease to the notifiable disease list is justified for which of the following reasons?
    1. If it is a communicable disease with a high case-fatality rate.
    2. If the problem is new and systematically collected data are needed to characterize the disease and its impact on the public.
    3. If a program at CDC has recommended its addition to better understand national trends and patterns.
    4. To guide, monitor, and evaluate programs to prevent or control the problem.
24. The case definition used for surveillance of a health problem should be the same as the case definition used for clinical (treatment) purposes.
    1. True.
    2. False.
25. A state health department decides to strengthen its notifiable disease reporting. The one best action to take is to …
    1. allow reporting through use of the Internet.
    2. require more disease-specific forms from local health departments.
    3. ensure that all persons with a responsibility to report understand the requirements and reasons for reporting and how reports will be used.
    4. reduce the number of diseases on the list.