Question

Ignaz Semmelweis was a physician practicing in Vienna BEFORE there was a germ theory of disease. He oversaw two delivery rooms, Clinic one, primarily staffed by physicians, and Clinic two, staffed by midwives. Semmelweis was severely troubled that his First Clinic had a much higher mortality rate due to puerperal fever than the Second Clinic. Observe the following data.

	First clinic				Second clinic
Year	Births	Deaths	Rate (%)		Births	Deaths	Rate (%)
1841	3,036	237	7.8		2,442	86	3.5
1842	3,287	518	15.8		2,659	202	7.6
1843	3,060	274	9.0		2,739	164	6.0
1844	3,157	260	8.2		2,956	68	2.3
1845	3,492	241	6.9		3,241	66	2.0
1846	4,010	459	11.4		3,754	105	2.8

Semmelweis' breakthrough occurred in 1847, following the death of his good friend Jakob Kolletscka, who had been accidentally poked with a student's scalpel while performing a post mortem examination. Kolletschka's own autopsy showed a pathology similar to that of the women who were dying from puerperal fever. Semmelweis immediately proposed a connection between cadaver contamination and puerperal fever.

Question 26 (2 points)

We now know that puerperal fever is caused by any number of bacteria that infect the female reproductive tract after childbirth. The RESERVOIR of these bacteria is likely ________.

Question 26 options:

	Cadavers
	Surgical instruments
	an Environmental source such as water
	Physicians hands

Question 27 (2 points)

What was the mode of transmission of the bacterial disease to Semmelweis's friend Jakob Kolletschka, who was nicked by a student's scalpe?

Question 27 options:

	Direct Contact Transmission
	Indirect Contact Transmission
	Droplet
	All of the above

Answer 1

26. Since Jakob kolletscka contracted bacterial disease after coming in contact with the scalpel that was used during post mortem examination suggests that the reservoir of these bacterial is likely to be Cadavers.

Also, since midwives which are not involved in handling post mortem examinations, didn't came in contact with the corpses and thus the bacteria, leading in lower mortality rate in the second clinic.

27. The mode of transmission is indirect transmission because there was no direct human-to-human contact. The transmission occured due to the nicking by scalpel harbouring the bacteria.