CM20.1-4 | Recent Advances in Community Medicine — Graded Quiz

Correct. COVID-19 is caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), a novel betacoronavirus first identified in Wuhan, China in December 2019. It is distinct from SARS-CoV-1 (2003) and MERS-CoV.

SARS-CoV-2 = COVID-19 causative agent; belongs to betacoronavirus genus; zoonotic origin via bats; PHEIC declared 30 January 2020; pandemic declared 11 March 2020.

Influenza A H1N1 caused the 2009 swine flu pandemic. MERS-CoV causes Middle East Respiratory Syndrome and has not caused a sustained pandemic. Ebola causes a viral haemorrhagic fever primarily in sub-Saharan Africa. The COVID-19 pandemic was caused by SARS-CoV-2.

Correct. The 2018 Nipah virus outbreak occurred in Kozhikode and Malappuram districts of Kerala, India. It resulted in 17 deaths (case fatality rate ~70%) and demonstrated healthcare worker infections, highlighting nosocomial transmission risk. Containment was achieved through rapid isolation and contact tracing.

Kerala Nipah 2018: Kozhikode district; index case from fruit bats (Pteropus giganteus); 17 deaths; healthcare worker infections; contained by isolation, contact tracing and IPC.

Bangladesh has had multiple Nipah outbreaks via date palm sap. Malaysia had the original 1998–99 outbreak with pigs as the intermediate host. West Bengal had a small 2001 outbreak. The 2018 outbreak with nosocomial transmission was in Kerala.

Correct. IDSP uses three reporting forms: P (Presumptive/syndromic) reported by community workers and health workers weekly; L (Laboratory) data from peripheral laboratories; C (Clinical) data reported by clinicians from health facilities. The P form enables early signal detection through syndromic surveillance.

IDSP P-L-C: P=Presumptive (syndromic, community-level, weekly); L=Laboratory (confirmed); C=Clinical (facility-based clinician report). IDSP feeds into the National Centre for Disease Control (NCDC).

Laboratory confirmed data is captured in the L form. Clinical data from clinicians is the C form. IDSP forms are disease surveillance tools — not demographic, census or post-outbreak evaluation forms.

Correct. SDG 3 'Good Health and Well-Being' is the health-focused Sustainable Development Goal under the 2030 Agenda. It covers targets including reducing maternal and child mortality, ending AIDS/TB/malaria, achieving Universal Health Coverage, and strengthening health systems — all directly relevant to community medicine practice.

SDG 3 targets relevant to India: 3.1 (maternal mortality <70/lakh), 3.2 (neonatal mortality <12/1000), 3.3 (end epidemic of AIDS/TB/malaria), 3.4 (NCD mortality reduction), 3.8 (Universal Health Coverage).

SDG 2 = Zero Hunger; SDG 3 = Good Health and Well-Being; SDG 4 = Quality Education; SDG 6 = Clean Water and Sanitation. Community medicine practitioners must be conversant with SDG 3 targets and India's progress.

Correct. The National Medical Commission Act was passed by Parliament in 2019 and came into force in September 2020, replacing the Medical Council of India (MCI) which had been operational since 1934. The NMC comprises four Autonomous Boards: Under-Graduate Medical Education Board (UGMEB), Post-Graduate Medical Education Board (PGMEB), Medical Assessment and Rating Board (MARB) and Ethics and Medical Registration Board (EMRB).

NMC Act 2020: Replaced MCI; four Autonomous Boards; National Exit Test (NExT) for licensure; 50% private medical college seats at government-regulated fees; Community Health Provider provision.

The NMC Act was passed in 2019 but enacted/operationalised in 2020. It did not come into force in 2017 or 2022. The key year to remember is 2020 when MCI ceased and NMC began functioning.

Correct. The PCPNDT Act 1994 (amended 2003) requires every State Government to appoint an Appropriate Authority at district, state and central levels. The Appropriate Authority is responsible for granting registration, conducting inspections, receiving complaints, and taking action against violators.

PCPNDT Act: prohibits sex selection pre/post conception and sex determination; Appropriate Authority = enforcement body; mandatory Form F for every sonography; non-compliance = cancellation of registration + criminal penalty.

The State Medical Council deals with medical practice regulation — not PCPNDT enforcement. NHRC handles human rights complaints. CBI is a criminal investigation agency. The PCPNDT enforcement mechanism is the Appropriate Authority.

Correct. Under the Telemedicine Practice Guidelines 2020, a text-only consultation (first contact with an unknown patient) permits prescription of OTC (over-the-counter) drugs only. Paracetamol is an OTC drug appropriate for symptomatic relief of fever and cold. Schedule H, H1 and X drugs require audio or video consultation and specific conditions.

Telemedicine prescribing by mode: Text-only → OTC only; Audio → OTC + Schedule H (for known patient); Video → OTC + H + H1 (follow-up known patient). Schedule X = never via telemedicine.

Schedule H drugs require audio or video consultation — not permitted in text-only mode. Schedule X drugs (habit-forming) are never permitted via telemedicine. Schedule H1 drugs (narrow therapeutic index/high risk) require video consultation for follow-up patients only — not for first-contact text consultations.

Correct. The Integrated Disease Surveillance Programme (IDSP), launched in 2004 under the National Health Mission, is India's primary outbreak detection and response system. It operates at district, state and national levels, collecting weekly P (presumptive), L (laboratory) and C (clinical) data, and triggers rapid response teams when outbreak signals are detected.

IDSP: launched 2004, funded by World Bank, operated under NCDC; weekly P-L-C reporting; District Surveillance Unit (DSU) at district level; State Surveillance Unit (SSU); Central Surveillance Unit (CSU) for national integration.

NFHS is a periodic household survey for demographic and health indicators — not outbreak surveillance. SRS measures vital events (birth and death rates). NAAQS monitors air quality — not disease outbreaks. IDSP is the designated disease surveillance platform.

Correct. Under IHR 2005 (Article 12), the WHO Director-General has the authority to declare a PHEIC after receiving advice from the Emergency Committee. The Emergency Committee is convened by the Director-General and comprises international experts. Since 2005, PHEICs have been declared for H1N1 (2009), Polio (2014), Ebola West Africa (2014), Zika (2016), Ebola DRC (2019), COVID-19 (2020), Mpox (2022, 2024).

PHEIC authority: WHO Director-General (Article 12, IHR 2005) → Emergency Committee advice → D-G decision. 7 PHEICs declared 2005–2024: H1N1, Polio, Ebola W. Africa, Zika, Ebola DRC, COVID-19, Mpox (×2).

The UN General Assembly does not declare PHEICs. The World Health Assembly (WHA) approves WHO regulations but does not declare PHEICs — that is the Director-General's prerogative under IHR 2005. Affected member states report potential PHEICs to WHO but do not have authority to declare them.

Correct. The ABHA (Ayushman Bharat Health Account), formerly Health ID, is a 14-digit unique digital health identifier. It is voluntary, not mandatory. Citizens can use it to consent to linking health records from hospitals, diagnostic labs and pharmacies — enabling a longitudinal, interoperable Personal Health Record across India's digital health ecosystem.

ABHA: 14-digit unique health ID; voluntary; requires Aadhaar/mobile; links health records with consent; part of ABDM (NHA). Distinct from PM-JAY (insurance) and HWC (service delivery).

ABHA registration is voluntary — not mandatory. PM-JAY (₹5 lakh insurance) is a separate programme. ABHA registration requires Aadhaar or mobile — not a caste certificate. ABHA is an identity and records-linking tool, not an insurance product.