ADVANCEMENT OF THE PRACTITIONER
JEH QUIZ
FEATURED ARTICLE QUIZ #6
Incorporating Novel Methods Into a Standard Environmental Legionnaires’ Disease Investigation and Identifying the Exposure Source of an Outbreak in New York
A
vailable to those with an active National Environmental Health Association (NEHA) membership, the JEH Quiz is offered six times per calendar year and is an easily accessible way to earn continuing education (CE) contact hours toward maintaining a NEHA credential. Each quiz is worth 1.0 CE. Completing quizzes is now based on the honor system and should be self-reported by the credential holder. Quizzes published only during your current credential cycle are eligible for CE credit. Please keep a copy of each completed quiz for your records. CE credit will post to your account within 3 business days. Paper or electronic quiz submissions will no longer be collected by NEHA staff. INSTRUCTIONS TO SELF-REPORT A JEH QUIZ FOR CE CREDIT 1. Read the featured article and select the correct answer to each JEH Quiz question. 2. Log in to your MyNEHA account at https://neha.users.membersuite.com/ home. 3. Click on Credentials located at the top of the page. 4. Select Report CEs from the drop-down menu. 5. Enter the date you finished the quiz in the Date Attended field. 6. Enter 1.0 in the Length of Course in Hours field. 7. In the Description field, enter the activity as “ JEH Quiz #, Month Year” (e.g., JEH Quiz 6, May 2024). 8. Click the Create button.
Quiz effective date: May 1, 2024 | Quiz deadline: August 1, 2024
1. Infections from Legionella are a leading cause of waterborne disease outbreaks in the U.S. a. True. b. False. 2. Almost all reported Legionnaires’ disease (LD) patients require hospitalization and the case fatality rate for LD is a. 5%. b. 7%. c. 9%. d. 11%. 3. An investigation was initiated by the New York State Department of Health after __ LD cases in the area were reported on August 21, 2019. a. three b. four c. five d. six 4. In total, __ potential cases were evaluated during the 2019 investigation. a. 19 b. 21 c. 23 d. 25 5. By 2021, __ cases were associated with the outbreak and __ total environmental samples were collected. a. 17; 64 b. 17; 74 c. 25; 74 d. 25; 84 6. A total of __ towers were sampled over the course of the investigation.
8. Other environmental sources sampled included a a. decorative fountain. b. swab of a humidifier. c. basement hose spigot. d. baseball field irrigation system. e. all of the above. 9. Sputum was collected from 14 of 25 potential cases and Lp1 was successfully cultured from __ out of 14 cases. a. 2 b. 4 c. 8 d. 12 10. A shortcoming of this investigation is that only 5 of the 17 identified cases associated with this outbreak could be traced via whole genome sequencing to any of the environmental sources tested. a. True. b. False. 11. The elevated level of iron detected in cooling tower E could have played a role in a. consuming the oxidizing biocide residual. b. promoting the growth of Legionella . c. interfering with methods of detecting Legionella species during sampling and analysis. d. all of the above. e. none of the above. 12. Overall, a cooling tower was identified as the potential __ source for at least five cases of LD in an outbreak investigation that spanned a 2-year period. a. direct b. indirect c. direct and indirect
a. 7 b. 9
c. 11 d. 13 7. Of all the environmental samples
JEH Quiz #4 Answers January/February 2024
collected, __ cultured positive for L. pneumophila serogroup 1 (Lp1).
1. a 2. d 3. b
4. d 5. a 6. d
7. a 8. c 9. b
10. b 11. a 12. c
a. 13 b. 15 c. 17 d. 19
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May 2024 • Journal of Environmental Health
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