Although epidemics are often triggered by bacteria and viruses that have undergone genetic mutations, as was the case with the Human Immunodeficiency Virus (HIV), which mutated into a harmful virus when it was transmitted from monkeys to humans, outbreaks of other diseases are caused by bacteria and viruses whose genetic make-ups have not undergone significant changes. In many cases, such diseases spread as a result of social factors.

Tuberculosis (TB) is a preventable and treatable disease that continues to infect thousands of Americans each year. The widespread global utilization of the BCG vaccine and antibiotics, in addition to generally improved public health, led to a dramatic reduction in both the number of deaths attributed to tuberculosis globally and in the economic burden of the disease between 1940 and 1980. But the short-term success of these tools led to complacency and a decreased interest on the part of governments and pharmaceutical companies in TB research and development. What resulted in the late 1980s in the United States, spurred by the spread of HIV and by the increase in homelessness, incarceration, and intravenous drug use, was a 20 percent increase in TB rates. These TB outbreaks were difficult to control and extremely costly, given that the health infrastructure for dealing with the infection had been allowed to deteriorate due to a lack of funding. In New York City alone, more than $1 billion was needed to regain control of TB.

Today, the United States faces three significant challenges to the elimination of TB. First, our progress in reducing the TB case rate in the United States has stalled. Between 1993 and 2000, the nation's TB rate fell by 7.3 percent, but from 2000 to 2006, the rate of decline slowed to 3.8 percent. This is occuring at a time when domestic TB control categorical funding has been stagnant for a decade. As the history of TB in the United States has demonstrated, complacency and neglect of TB control programs can lead to costly resurgences of the disease.

It can be inferred from the passage that HIV affected monkeys in which of the following ways?


A. it kills them
B. it alters their genetic makeups
C. it does not negatively impact them
D. it is transmitted from one monkey to another
E. it spreads as a result of social factors

OA: C. I don't think any of the options are right for this question.