1. In the early 2000s, what two illnesses caused the most deaths of children worldwide?

1. Meningococcal disease and smallpox
2. Varicella (Chickenpox) and measles
3. Pneumonia and severe diarrhea
4. Influenza and diphtheria

Supplementary information: The correct answer is C. In the early 2000s, pneumonia and severe diarrhea caused the deaths of about 3 million children per year. These numbers are continuing to decrease as vaccines for pneumococcus and rotavirus become more widely available.

2. What vaccine-preventable disease has also been called the 100-day cough?

1. Pertussis
2. Pneumococcal disease
3. Varicella (Chickenpox)
4. Meningococcal disease

Supplementary information: The correct answer is A. Pertussis, or whooping cough, occurs in three stages with cold-like symptoms occurring during the first stage. Intense and prolonged coughing occurs during the second and third stages, typically lasting for weeks or several months.

3. Some diseases are only found in humans; however, influenza can infect many types of animals. Which animals can also get influenza?

1. Birds, aquatic birds, pigs, horses, dogs, cats and sea mammals
2. Bears and deer
3. Lemurs, lions and tigers
4. Elephants, zebra, buffalo and meerkats

Supplementary information: The correct answer is A. Besides infecting humans, influenza virus can infect birds, aquatic birds, pigs, horses, dogs, cats and sea mammals. Occasionally, an animal, such as a pig, will be infected with multiple strains that combine to form a new strain that can infect humans. This can lead to a pandemic.

4. What disease could be prevented by a vaccine, but isn’t?

1. Varicella (Chickenpox)
2. Lyme disease
3. Shingles
4. Hepatitis A

Supplementary information: The correct answer is B. A vaccine for Lyme disease was available from 1998 to 2002. However, because of unfounded safety concerns and lack of use, it was removed from the market. Because a vaccine is no longer available, people can protect themselves by wearing protective clothing and inspecting themselves for ticks after potential exposure.

5. Which vaccine-preventable disease is not affected by herd immunity?

1. Influenza
2. Measles
3. Mumps
4. Tetanus

Supplementary information: The correct answer is D. Because tetanus does not spread from person to person, people cannot be protected from the disease just because everyone around them has been vaccinated. So, the best way to protect yourself from tetanus is to receive the tetanus vaccine.

6. What disease did parents want their children to share before the vaccine was available?

1. Polio
2. Varicella (Chickenpox)
3. Rotavirus
4. Haemophilus influenzae type B (Hib)

Supplementary information: The correct answer is B. Before the chickenpox vaccine was available, parents would intentionally expose their children to others with chickenpox so they could become infected and gain immunity during childhood, when the disease is typically less severe.

7. Which disease is known to be more commonly spread from adults to children?

1. Varicella (Chickenpox)
2. Pertussis (Whooping Cough)
3. Measles
4. Rubella

Supplementary information: The correct answer is B. Typically, children spread infections to adults; however, pertussis (whooping cough) is more commonly spread from adults to children. For this reason, adults who are going to be around young infants are recommended to get one dose of Tdap vaccine. Protecting babies by immunizing those around them is known as cocooning.

8. Which vaccine-preventable disease used to be commonly known as German measles?

1. Rubella
2. Measles
3. Smallpox
4. Cholera

Supplementary information: The correct answer is A. Rubella is also known as German measles because it was first described in German medical literature as a disease distinct from measles and scarlet fever.

9. Whooping cough is the common name for what vaccine-preventable disease?

1. Smallpox
2. Measles
3. Pertussis
4. Tetanus

Supplementary information: The correct answer is C. Whooping cough is the common name for pertussis because of the characteristic whooping sound that occurs when someone tries to breathe in against a narrowed windpipe after a coughing spell.

10. Which disease no longer infects any person in the world because of successful vaccination programs?

1. Polio
2. Smallpox
3. Rotavirus
4. Diphtheria

Supplementary information: The correct answer is B. Smallpox is currently the only disease to be eradicated from the world by a vaccine. Efforts are underway to add polio to the list of eradicated diseases.

11. What infectious disease was the only one that we could prevent in the 1700s?

1. Smallpox
2. Mumps
3. Diphtheria
4. Tuberculosis

Supplementary information: The correct answer is A. Smallpox was the first disease to be successfully prevented with vaccination. In the late 1700s, Edward Jenner developed the technique of inoculating people with cowpox to prevent smallpox.

12. What vaccine-preventable disease were travelers to the 2012 London Olympics warned to be immunized against?

1. Measles
2. Diphtheria
3. Polio
4. Rotavirus

Supplementary information: The correct answer is A. Measles outbreaks were occurring in Europe due to decreased immunization rates in that region; therefore, travelers to the 2012 London Olympics were warned to be immunized against measles.

13. Which of the following pairs are vaccine-preventable diseases transmitted by mosquitos?

1. Yellow fever and Japanese encephalitis virus
2. Measles and Mumps
3. Varicella (chickenpox) and Lyme disease
4. Cholera and rubella

Supplementary information: The correct answer is A. Yellow fever and Japanese encephalitis virus are two vaccine-preventable diseases that are transmitted by mosquitos, but vaccines are typically only given to high-risk groups, such as some travelers.

14. The American Red Cross held a campaign to raise funds for distribution of what vaccine?

1. Polio
2. Measles
3. Hepatitis B
4. Rotavirus

Supplementary information: The correct answer is B. In 2001, the American Red Cross, in conjunction with the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), UNICEF, and United Nations Foundation, launched the Measles and Rubella Initiative, a worldwide vaccination campaign that has successfully vaccinated 1 billion children in 80 developing countries.

15. Rotary International held a campaign to raise funds for what vaccine?

1. Rotavirus
2. HPV
3. Polio
4. Hepatitis A

Supplementary information: The correct answer is C. Rotary International began the End Polio Now campaign to raise funds to provide polio vaccine to children in areas where infectious polio still exists and to help eradicate polio from the world. Other groups also working in this campaign include the Bill and Melinda Gates Foundation, Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and UNICEF.

16. Lyme disease gets its name from a town in what U.S. state where a cluster of cases occurred in the 1970s?

1. Connecticut
2. Arkansas
3. New Jersey
4. Florida

Supplementary information: The correct answer is A. In 1975, large numbers of children were diagnosed with rheumatoid arthritis in Lyme, Connecticut. Researchers soon found that most of the children lived in wooded areas and symptoms typically started during the summer. It was not long before scientists determined that Lyme disease was transmitted by tick bites.

17. Botox™ uses a diluted form of the toxin produced by what bacteria?

1. Corynebacterium diphtheriae
2. Haemophilus influenzae type B
3. Clostridium botulinum
4. Neisseria meningitidis

Supplementary information: The correct answer is C. Botox is a very dilute form of the neurotoxin produced by Clostridium botulinum. Wrinkles are caused by facial muscles that continually contract; Botox treats wrinkles by relaxing these muscles.

18. What vaccine-preventable disease used to be commonly known as “wool sorters disease”?

1. Anthrax
2. Yellow Fever
3. Japanese encephalitis virus
4. Measles

Supplementary information: The correct answer is A. Anthrax was commonly referred to as “wool sorters disease” because sheep wool was commonly contaminated with Bacillus anthracis, the bacteria that causes anthrax.

19. What vaccine-preventable disease is transmitted from one person to another through contact with an infected person’s blood?

1. Chickenpox
2. HPV
3. Hepatitis B
4. Influenza

Supplementary information: The correct answer is C. The blood of a person infected with hepatitis B typically contains very high quantities of the virus. Therefore, others can be infected by contact with tiny amounts of blood that cannot be seen with the naked eye, such as on washcloths and toothbrushes.

20. What vaccine-preventable disease can be spread in restaurants via contaminated food or by infected workers who do not properly wash their hands?

1. Hepatitis A
2. HPV
3. Hepatitis B
4. Measles

Supplementary information: The correct answer is A. Hepatitis A is commonly transmitted through food that has not been cleaned properly or has been handled by someone with hepatitis A. Although we don’t often hear about them, hepatitis A outbreaks occur every year in the United States.

21. What vaccine-preventable disease used to be the leading cause of bacterial meningitis in children less than 5 years old?

1. HPV
2. Haemophilus influenzae type B
3. Mumps
4. Diphtheria

Supplementary information: The correct answer is B. Before introduction of the vaccine, Hib used to be the leading cause of bacterial meningitis in children less than 5 years of age. As a result, Hib was also the most common cause of mental retardation in this age group.

22. What is one of the most common sexually transmitted infections in the U.S.?

1. HPV
2. HIV
3. Hepatitis A
4. Hepatitis B

Supplementary information: The correct answer is A. HPV is one of the most commonly occurring sexually transmitted diseases in the U.S. HPV infects both men and women and about 6 million new infections occur every year.

23. What vaccine-preventable disease can cause death within hours of infection?

1. Shingles
2. Chickenpox
3. Pertussis (whooping cough)
4. Meningococcal disease

Supplementary information: The correct answer is D. Death can occur within hours of being infected with Neisseria meningitidis, the bacteria that causes meningococcal disease. Those who survive meningococcal infection usually have permanent disabilities, such as limb amputation, hearing loss, brain damage and kidney failure.

24. What vaccine-preventable disease is a common cause of severe diarrhea in infants and young children in the U.S.?

1. Chickenpox
2. Rubella
3. Rotavirus
4. Pneumococcal disease

Supplementary information: The correct answer is C. Rotavirus is the most common cause of severe diarrhea in infants and young children in the U.S. In fact, before a vaccine was available, rotavirus infected about 3 million children every year in the U.S.

25. The name of what vaccine-preventable disease is derived from the Greek word meaning ‘leather hide’?

1. Diphtheria
2. Tetanus
3. Pertussis (whooping cough)
4. Rubella

Supplementary information: The correct answer is A. A common symptom of diphtheria is the presence of a thick layer that forms in the back of the throat. For this reason, the disease was named ‘diphtheria,’ derived from the Greek word meaning ‘leather hide’.

26. What vaccine-preventable disease is often referred to as “lock jaw”?

1. Rotavirus
2. Smallpox
3. Tetanus
4. Measles

Supplementary information: The correct answer is C. Tetanus is commonly referred to as “lock jaw” because infection typically causes intense and painful muscle spasms, including the muscles of the head and neck.

27. How many types of HPV have been identified?

1. About 50
2. More than 100
3. About 75
4. Less than 10

Supplementary information: The correct answer is B. More than 100 types of HPV have been identified. Some have been found to cause disease. Types 16 and 18 are the most common causes of cervical cancer and types 6 and 11 are the most common causes of anal and genital warts.

28. What virus is closely related to the virus that causes distemper in dogs?

1. Rotavirus
2. Rubella virus
3. Mumps virus
4. Measles virus

Supplementary information: The correct answer is D. Measles virus is closely related to the virus that causes distemper in dogs. In the past, dogs were vaccinated with the measles vaccine in order to prevent distemper.

29. What virus causes swelling of the glands of the head and neck, often making infected individuals look like chipmunks?

1. Measles virus
2. Mumps virus
3. Influenza virus
4. Rubella virus

Supplementary information: The correct answer is B. Mumps virus infects the salivary glands in about 35 of 100 people infected with the virus. When these glands begin to swell, the infected person often looks like a chipmunk.

30. What virus can live silently in nerves for years after an initial infection, later awakening due to age or a weakened immune system?

1. Mumps virus
2. Rubella Virus
3. Chickenpox virus
4. Measles virus

Supplementary information: The correct answer is C. After chickenpox infection, varicella zoster virus lives silently in the nerves. As people age, their immune system weakens, sometimes leading to a reawakening of the zoster virus, causing shingles.

31. Which vaccine-preventable disease can occur when a wound or cut is exposed to soil that contains bacteria?

1. Pertussis
2. Tetanus
3. Meningococcal disease
4. Pneumococcal disease

Supplementary information: The correct answer is B. Tetanus typically occurs when a wound or cut is exposed to soil that contains Clostridium tetani. Because infection occurs via bacteria introduced in the soil, this disease is not one that people can be protected against by living in a highly vaccinated community.

32. What vaccine-preventable disease is spread by food or water contaminated with the feces of an infected person?

1. Rubella
2. Polio
3. Meningococcal disease
4. Pneumococcal disease

Supplementary information: The correct answer is B. Polio virus is found in the intestines and typically spreads by food or water that is contaminated with the feces of an infected person. Sometimes, polio virus spreads in saliva. 

33. What vaccine-preventable disease cannot be spread from one person to another?

1. HPV
2. Tetanus
3. Chickenpox
4. Measles

Supplementary information: The correct answer is B. Tetanus is the only vaccine-preventable disease that does not spread from person to person. People infected with tetanus are typically exposed when a wound comes in contact with contaminated soil. For this reason, herd immunity, as provided by high vaccination rates, does not apply to this disease.

34. What vaccine-preventable disease can be particularly deadly for the elderly?

1. Pneumococcal disease
2. Shingles
3. Measles
4. Rotavirus

Supplementary information: The correct answer is A. Pneumococcal disease is known as an opportunistic infection because it usually attacks when a person’s immune system is already weakened by another infection. Pneumococcus is particularly deadly in elderly people when it causes pneumonia during recovery from an influenza infection.

35. What vaccine-preventable diseases are spread through tiny droplets that hang in the air?

1. Hepatitis B and HPV
2. Chickenpox and shingles
3. Measles and chickenpox
4. Smallpox and pertussis

Supplementary information: The correct answer is C. Measles and chickenpox viruses spread through respiratory droplets that hang in the air. Infections with either virus are typically more severe in adults than children.

36. What vaccine-preventable disease was not distinguished from smallpox until the end of the 19th century?

1. Tetanus
2. Rubella
3. Chickenpox
4. Pertussis

Supplementary information: The correct answer is C. Because chickenpox and smallpox both caused rash-like illnesses, the two diseases were not realized as different until the end of the 19th century.

37. Infection with what virus can cause cirrhosis and liver disease?

1. HPV
2. Hepatitis B virus
3. Measles virus
4. Mumps virus

Supplementary information: The correct answer is B. People with chronic hepatitis B infection typically suffer severe liver damage, known as cirrhosis, which often results in liver disease or liver cancer. Because most people do not show symptoms of chronic infection, they do not know they are infected until they are diagnosed with liver cancer.

38. What vaccine-preventable disease used to be referred to as “the strangling angel of children”?

1. Diphtheria
2. Smallpox
3. Pertussis
4. Chickenpox

Supplementary information: The correct answer is A. Diphtheria was called “the strangling angel of children” because of the thick membrane that develops in the back of the throat, often covering airways and causing suffocation.

39. What vaccine-preventable disease has a symptom known as “bullneck”?

1. Mumps
2. Rubella
3. Smallpox
4. Diphtheria

Supplementary information: The correct answer is D. A common symptom of diphtheria is “bullneck,” a condition in which the glands in the neck become swollen, often making the infected person look like they have a bull’s neck.

40. The Iditarod was originally organized to deliver antiserum for what vaccine-preventable disease?

1. Diphtheria
2. Pertussis
3. Chickenpox
4. Tetanus

Supplementary information: The correct answer is A. The Alaskan Iditarod was originally organized in 1925 to deliver diphtheria antiserum to Nome, Alaska. Twenty mushers and 150 sled dogs traversed about 674 miles across Alaska in attempt to stop a diphtheria outbreak that was occurring in the town and surrounding areas.

41. Low immunization rates in the U.S. during the late 1980s and early 1990s led to an outbreak of what vaccine-preventable disease?

1. Haemophilus influenzae type B (Hib)
2. Polio
3. Measles
4. Mumps

Supplementary information: The correct answer is C. Low immunization rates in the U.S. led to a measles outbreak during the late 1980s and early 1990s. In California alone, 16,400 people were infected, almost 4,000 were hospitalized and 75 died.

42. Which vaccine-preventable diseases can cause meningitis?

1. Pneumococcal disease, meningococcal disease and Haemophilus influenzae type B
2. Chickenpox, shingles and diphtheria
3. HPV and hepatitis B
4. Hepatitis A, tetanus and pertussis

Supplementary information: The correct answer is A. Meningitis, or the swelling of the lining of the brain and spinal cord, is a possible complication of infection with Haemophilus influenzae type B, meningococcus and pneumococcus. Symptoms of meningitis can include stiff neck, fever, vomiting, headache, seizures and coma.

43. People without a spleen are more susceptible to which diseases?

1. Pneumococcal and meningococcal diseases
2. Chickenpox and measles
3. Diphtheria and pertussis
4. Polio and Rotavirus

Supplementary information: The correct answer is A. People without a spleen are more susceptible to pneumococcus and meningococcus. For this reason, they are recommended to receive vaccines to prevent these diseases.

44. What vaccine-preventable disease cannot be successfully treated with antibiotics because it is a virus?

1. Influenza
2. Pertussis (Whooping cough)
3. Haemophilus influenzae type B
4. Tetanus

Supplementary information: The correct answer is A. Because influenza is caused by a virus, it cannot be treated with antibiotics. Antiviral medicines, however, may work.

45. A study published in 1989 found what concentration of virus particles in sea water?

1. 25 virus particles per milliliter
2. 2500 virus particles per milliliter
3. 250,000 virus particles per milliliter
4. 250 million virus particles per milliliter

Supplementary information: The correct answer is D. A study published in 1989, which examined the presence of viruses in sea water, found about 250 million virus particles in every milliliter of sea water.

46. What is believed to be one of the roles viruses play within the environment?

1. To facilitate diversity by making sure no one type of bacteria becomes dominant
2. To create coral reefs in the tropics
3. To remove algae from the water’s surface
4. To create optimal conditions for plant growth and survival

Supplementary information: The correct answer is A. Viruses play many roles in the environment, including facilitating biodiversity so that one type of bacteria does not become dominant.

47. A genetic mutation has helped people with sickle cell anemia be protected against what infectious disease?

1. Yellow fever
2. Malaria
3. Diphtheria
4. Tetanus

Supplementary information: The correct answer is B. The gene mutation that causes sickle cell anemia is an example of adaptation, or the changing of oneself so as to adapt to a changing environment. Sickle cell anemia causes sickle-shaped red blood cells that protect people from malaria because the virus that causes malaria cannot enter red blood cells of this shape.

48. What virus can occur in both humans and chimpanzees?

1. Polio
2. Hepatitis B
3. HPV
4. Rubella

Supplementary information: The correct answer is A. Besides humans, polio virus can also infect chimpanzees. For this reason, scientists tested the effectiveness of potential polio vaccines in chimpanzees prior to their use in humans.

49. What vaccine-preventable disease kills almost everyone it infects?

1. Polio
2. Rubella
3. Chickenpox
4. Rabies

Supplementary information: The correct answer is D. Rabies is typically transmitted to humans through the bite of an infected animal. Rabies virus infects the brain causing encephalitis and ultimately death within days of the onset of symptoms.

50. What vaccine-preventable disease killed almost 90 percent of Aztec, Inca and Maya civilizations?

1. Rubella
2. Polio
3. Smallpox
4. Diphtheria

Supplementary information: The correct answer is C. The impact of smallpox on Native American populations is a dramatic illustration of how shipping and European colonization of the Americas also caused the transmission of previously unknown vaccine-preventable diseases to susceptible populations.

51. What percent of the world’s population is immunodeficient?

1. 1 of 100
2. 10 of 100
3. 50 of 100
4. 75 of 100

Supplementary information: The correct answer is A. Immunodeficiency is defined as the inability to generate a normal immune response. In fact, 1 of 100 people are immunodeficient and, therefore, may be unable to receive certain vaccines. For this reason, high vaccination rates are important in providing protection to this group.

52. What company made a system to help track suspected influenza?

1. Google
2. Facebook
3. Apple
4. Microsoft

Supplementary information: The correct answer is A. Google created Google Flu Trends to learn about influenza interest in the community based on internet searches.

53. What annual sporting event was cancelled as a result of the 1919 influenza pandemic?

1. The World Series
2. The Stanley Cup
3. The NBA Finals
4. Wimbledon

Supplementary information: The correct answer is B. The final game in the 1919 Stanley Cup Finals was cancelled after the coach and multiple players of the Montreal Canadiens were hospitalized with influenza. After both the Canadiens and Seattle Metropolitans won two games and tied the fifth game, the sixth game was supposed to determine the winner of the competition. Because the coach of the Canadiens couldn’t put a full team on the ice for the last game, he forfeited; however, the coach of the Metropolitans refused to accept the forfeit. As a result, no winner was declared for the 1919 Stanley Cup Finals.

54. In Africa, many families do not name their children until the threat of what vaccine-preventable disease has passed?

1. Rubella
2. Measles
3. Pertussis
4. Polio

Supplementary information: The correct answer is B. Many families do not name their children until the threat of measles has passed. This common practice in Africa inspired Sophie Blackall, a gifted illustrator, to create posters for the Measles and Rubella Initiative, which document the ongoing initiative to end measles.

55. In the 1960s, mirrors were removed from the rooms of female patients suffering from what vaccine-preventable disease?

1. Smallpox
2. Measles
3. Chickenpox
4. Polio

Supplementary information: The correct answer is A. Due to the disfigurement caused by smallpox, mirrors were removed from rooms of female sufferers so they would not see themselves. Some survivors committed suicide rather than live with their disfigured appearance.

56. Rashes caused by which two vaccine-preventable diseases were commonly confused in the pre-vaccine era?

1. Measles and chickenpox
2. Rubella and smallpox
3. Smallpox and chickenpox
4. Rubella and measles

Supplementary information: The correct answer is C. Smallpox rashes were most commonly confused with chickenpox but also sometimes confused with measles and syphilis rashes.

57. Which VPD could be so disfiguring that survivors would not be recognizable?

1. Mumps
2. Measles
3. Smallpox
4. Rubella

Supplementary information: The correct answer is C. Smallpox was so disfiguring that in the late 1800s, Sister Isla Stewart used the following anecdote to describe it: Two sisters in a camp sat at the same table for a week without recognizing each other.

58. Which vaccine-preventable disease wiped out tribes of Native Americans when introduced in the New World?

1. Polio
2. Smallpox
3. Hepatitis A
4. Pertussis

Supplementary information: The correct answer is B. Aztecs and Incas in South American and Algonquins and Narrangassetts in North America were essentially destroyed by smallpox infection introduced by settlers. In some cases, ten diseases were spread intentionally by offering the Natives blankets and harbor ships contaminated with smallpox pus.

59. Lady Mary Montague, whose husband was an English ambassador in Turkey during the 1700s wrote home describing parties to intentionally share what vaccine-preventable disease?

1. Polio
2. Hepatitis A
3. Smallpox
4. HPV

Supplementary information: The correct answer is C. Older women in the communities in Turkey would set up “parties” for 15 or 16 people who wished to get inoculated in the arm with pus from someone with a mild case of smallpox. They referred to the procedure as ingrafting.

60. What vaccine-preventable illness caused a global pandemic in 1918?

1. Influenza
2. Polio
3. Smallpox
4. Measles

Supplementary information: The correct answer is A. The global influenza pandemic of 1918 killed 25 million people, roughly three times more than all the casualties of World War I, which ended the same year.

61. Currently, how many iron lungs are estimated to be in service on any given day in the U.S.?

1. 150
2. 100
3. 45
4. 30

Supplementary information: The correct answer is D. Iron lungs are currently used to help wean non-polio patients off today’s ventilators.

62. What was the name of the cow famous for its role in Edward Jenner’s smallpox vaccination experiments?

1. Daisy
2. Betty
3. Bessie
4. Blossom

Supplementary information: The correct answer is D. Blossom was infected with cowpox, which Jenner used to develop a smallpox vaccine.

63. Victims of what vaccine-preventable disease were buried in putty sealed coffins filled with formalin soaked sawdust even as late as the 1960s?

1. Polio
2. Smallpox
3. Meningitis
4. Mumps

Supplementary information: The correct answer is B. Formalin is a power denaturing compound used to destroy the chemical structure of proteins in everything from human tissue to capsule of viruses.