I.

ANSWER 6 FROM 12 QUESTIONS !

1.

Explain the definition of

measles?
2. Explain the definition of
diarrhea?
3. Explain the definition of
malaria?
4. Explain the definition of polio?
5. Explain the definition of
influenza?
6. Explain the definition of Ebola
influenza?
7. Explain the symtoms and how
to cure measles?
8. Explain the symtoms and how
to cure diarrhea?
9. Explain the symtoms and how
to cure malaria?
10. Explain the symtoms and how
to cure polio?

11. Explain the symtoms and how

to cure influenza?
12. Explain the symtoms and how
to cure ebola influenza?
II. ANSWER 4 FROM 6 QUESTIONS !
Find the Subject and Predicate!
13.

In 1988, the World Health Organization (WHO) had a goal (S) of eradicating
(P) the poliovirus worldwide by the year 2000. The last wild virus case in
the Western Hemisphere was in Peru in 1991. One type of poliovirus
(Type 2) (S) was apparently eradicated (P) after October 1999. (5) The
latest figures from the Wild Poliovirus Weekly Update show 790 cases
globally as of December 4, 2007. The latest reported case was November 8,
2007 in Nigeria. Compared to 2006 year to date numbers, there has been a
55% reduction wild poliovirus cases. (10)
The best prevention (S) is (P) of course eradication, hence the global effort
to eradicate the wild strains of the poliovirus by vaccinations. The next
important effort is reduce and eventually eliminate VAPP cases. Inactivated
poliovirus vaccines (IPV) do not contain live virus, so they cannot cause
VAPP.

However, there are some complications with IPV, although no

serious adverse reactions have been documented. The US has eliminated

VAPP cases by going exclusively to this vaccine. Additional immunization
development has been to combine the IPV with the diphtheria, pertusiss,
tetanus and hepatitis B vaccines. Children should be immunized at 2, 4, and
6 months of age with this pentavalent vaccine and at 18 weeks with just IPV.
(5) One final preventive method is good hygiene, especially in areas where
the virus may still be present.

An extremely serious complication of measles infection is

the inflammation and subsequent swelling of the brain.
Called encephalitis, this can occur up to several weeks after
the basic measles symptoms have resolved. About one out
of every 1,000 patients develops this complication, and
about 1015% of these patients die. Symptoms include
fever, headache, sleepiness, seizures, and coma. Long-term
problems following recovery from measles encephalitis may
include

seizures

and

mental

retardation.A

very

rare

complication of measles can occur up to 10 years or more

following the initial infection. Called subacute sclerosing
panencephalitis, this is a
14.

slowly progressing, smoldering, swelling, and destruction of

the entire brain. It is most common among people who had
measles infection prior to the age of two years. Symptoms
include changes in personality, decreased intelligence with
accompanying school problems, decreased coordination,
and involuntary jerks and movements of the body. As the
disease

progresses,

the

patient

becomes

increasingly

dependent, ultimately becoming bedridden and unaware of

his or her surroundings.
15.

In 1998 the MMR vaccine controversy in the United

Kingdom (S) regarding (P) a potential link between the
combined MMR vaccine (vaccinating children from mumps,
measles and rubella) and autism prompted a reemergence
of the "measles party", where parents deliberately expose
their child to measles in the hope of building up the child's

immunity without an injection. This practice poses (S)

many health risks to the child, and has been discouraged
(P) by the public health authorities.[10] Scientific evidence
provides no support for the hypothesis that MMR plays a role
in causing autism.[11] In 2009, The Sunday Times (S)
reported (P) that Wakefield had manipulated patient data
and misreported results in his 1998 paper, creating the
appearance of a link with autism. [12] The Lancet fully (S)
retracted (P) the 1998 paper on 2 February 2010. [13] In
January 2010, another study of Polish children found that
vaccination with the measles,mumps,and rubella vaccine
was not a risk factor for development of autistic disorder, in
fact the vaccinated patients (S) had a slightly reduced
(P) risk of autistic disorder, although the mechanism of
action behind that is unknown,and this result may have
been coincidental.[14][not specific enough to verify]
The autism related MMR study in Britain caused use of the
vaccine to plunge,

and measles cases came back: 2007

saw 971 cases in England and Wales, the biggest rise in

occurrence in measles cases since records began in 1995. [15]
A 2005 measles (S) outbreak in Indiana was attributed (P)
to children whose parents refused vaccination. [16]
16.

In the United States, the incidence of paralytic

poliomyelitis (S) declined (P) from more than 21,269
cases

in

1952

(prior

to

vaccine

availability)

to

consistently less than 100 cases by the mid 1960s. (8)

The last cases of paralytic poliomyelitis caused by wild
virus in the US occurred during an outbreak among

the Amish in 1979, although it had been brought in

from the Netherlands.

Over the next 20 years, there

was an average of 8 cases per year, most (95%) being

caused by the use of the oral, live, attenuated virus
(OPV).

To reduce the number of vaccine-associated

paralytic polio (VAPP) cases, the OPV was phased out.

The last case of VAPP acquired in the US was in 1999.
The latest VAPP case in the US was in 2005 when an
individual was infected with polio vaccine virus in Costa
Rica

and

subsequently

developed

paralytic

poliomyelitis. Also in 2005, four unvaccinated children

in an Amish community in Minnesota were diagnosed
with asymptomatic or inapparent polio.

According to

the CDC, The source of the vaccine virus has not been
determined, but it appeared to have been circulating
among humans for at least 2 years based on genetic
changes in the virus. (5, 9)

17.

A prodromal(S) period of several days may involve no

symptoms or symptoms of a minor illness that seems
to go away. The severe symptoms(S) will last 2 to
10 days (P) and consist of moderate fever, headache,
vomiting,

diarrhea,

excessive

tiredness,

fatigue,

irritability, and pain or stiffness of the neck, back, arms,

legs, abdomen.

Less than 1% of all polio infections

result in flaccid paralysis, hence the name paralytic

poliomyelitis.

These symptoms occur after a 1 to 10

days prodrome with paralytic symptoms developing

over the next 2 to 3 days. In some cases, such as with

children, the prodrome may be broken up into two
phases, a minor phase similar to the prodromes of the
other polios, and a major phase. This phase (S) could
involve symptoms such as a loss of superficial reflexes
and severe muscle aches and spasms.
acute(S)

infection

progresses(P),

As the

the

following

symptoms develop: severe constipation, stiff neck and

back,

difficulty

beginning

to

urinate,

weakened

breathing, difficulty swallowing, hoarse or nasally voice,

abnormal sensations (but not loss of sensation) of an
area,

sensitivity

to

touch,

muscle

pain,

muscle

contractions or muscle spasms (particularly in the calf,

neck, or back), and asymmetrical muscle weakness
progressing to flaccid paralysis.

This paralysis may

remain at one level for days to weeks before recovery.

Many can recover to full strength. However, weakness
or

paralysis

present

12

months

later

is

usually

permanent. (1, 2, 4, 5) In the 1980s, doctors identified

characteristics of a post-polio syndrome affecting 25%40% of persons who contracted paralytic poliomyelitis
in childhood.

After an interval of 30-40 years, these

individuals experienced new muscle pain, increased

weakness in already weak areas, new weakness or
paralysis. It should be noted that this syndrome is not
an infectious process. (5)

18.

By the time a patient (S) is hospitalized (P), a

fourfold

rise

in

antibody

may

not

materialize.

Successful isolation of a particular strain of

poliovirus (S) is can be done (P) with samples taken
from an infected persons stool or pharynx.

Further

testing (S) of the isolated (P) virus is necessary for

individuals exhibiting an acute infection in order to
determine if the virus is a wild type (the virus that
causes the disease) or a vaccine type (virus derived
from a vaccine strain).

This in-depth testing

involves (S) using oligonucleotide mapping (P)

(fingerprinting) or genomic sequencing. (5)
Most sources (S) attribute (P) the earliest recognition
and

clinical

description

of

poliomyelitis

Underwood in England back in 1789. (5, 6)

to

Michael

However,

references to crippling diseases (S) do (P) go back to

antiquity such as on a 1300 B.C. Egyptian stone engraving.
(7) The actual naming of the disease (s) could not be
determined (P) although it was likely done by Jacob Heine
in 1840. He (S) was the first to describe (P) the clinical
features of the disease as well as its involvement of the
spinal

cord.

(6)

The

name(S)

indicates

(P)

an

inflammation (-itis) and is derived from the Greek words

polio (for grey) and myelon (marrow, or in this case, spinal
cord). The first outbreaks(S) reported (P) in the United
States were in 1843, with the first US epidemic starting in
Vermont in 1894.
development

of

the

For the 100 years prior to the

vaccine,

epidemics

(S)

were

reported (P) in the entire Northern Hemisphere every

summer and fall, becoming more severe with time. In 1908,
Karl Landsteiner and Erwin Popper (S) became (P) the
first to identify a virus as the cause of polio.

(All three

strains were later identified over the next 60 years.) (5, 6)