Professional Documents
Culture Documents
1) Strategy formulation or strategic planning begins with a(n) ________, which is the process of
finding a strategic fit between external opportunities and internal strengths while working around
external threats and internal weaknesses.
A) environmental analysis.
B) position analysis.
C) strategic evaluation.
D) objective analysis.
E) situation analysis.
Answer: E
Difficulty: Easy
Learning Obj.: 6.1: Utilize the SFAS matrix and a SWOT diagram to examine business strategy
AACSB: Analytical thinking
2) One desired outcome of analyzing strategic factors is identifying niches where an organization
can use its ________ to take advantage of a particular market opportunity.
A) differentiating capabilities.
B) distinctive competencies.
C) situational proficiency.
D) core competencies.
E) distinctive characteristics.
Answer: D
Difficulty: Moderate
Learning Obj.: 6.1: Utilize the SFAS matrix and a SWOT diagram to examine business strategy
AACSB: Analytical thinking
3) An acronym for the assessment of the external and internal environments of the business
corporation in the process of strategy formulation/strategic planning is
A) PET.
B) MBO.
C) SWOT.
D) SBU.
E) ROI.
Answer: C
Difficulty: Easy
Learning Obj.: 6.1: Utilize the SFAS matrix and a SWOT diagram to examine business strategy
AACSB: Application of knowledge
1
Copyright © 2018 Pearson Education, Inc.
4) The T in SWOT represents
A) threat.
B) tactic.
C) technique.
D) task.
E) time.
Answer: A
Difficulty: Easy
Learning Obj.: 6.1: Utilize the SFAS matrix and a SWOT diagram to examine business strategy
AACSB: Application of knowledge
2
Copyright © 2018 Pearson Education, Inc.
8) The goal of strategy is to find a(n) ________ that is so well suited to the firm's competitive
advantages that other organizations are not likely to challenge or dislodge it.
A) strategic fit.
B) propitious niche.
C) common thread.
D) business screen.
E) implicit strategy.
Answer: B
Difficulty: Moderate
Learning Obj.: 6.1: Utilize the SFAS matrix and a SWOT diagram to examine business strategy
AACSB: Application of knowledge
9) According to the text, unique market opportunities that are available for only a particular time
are called
A) situational occasions.
B) critical openings.
C) strategy implementation.
D) strategic windows.
E) trigger points.
Answer: D
Difficulty: Moderate
Learning Obj.: 6.1: Utilize the SFAS matrix and a SWOT diagram to examine business strategy
AACSB: Application of knowledge
11) The matrix that summarizes an organization's strategic factors by combining the external
factors from the EFAS Table with the internal factors from the IFAS Table is called a(n)
A) Total Weighted Score.
B) SWOT Matrix.
C) SFAS Matrix.
D) TOWS Matrix.
E) Issues Priority Matrix.
Answer: C
Difficulty: Moderate
Learning Obj.: 6.1: Utilize the SFAS matrix and a SWOT diagram to examine business strategy
AACSB: Application of knowledge
3
Copyright © 2018 Pearson Education, Inc.
12) In a SFAS Matrix,
A) all strategic factors are weighted equally.
B) the number of strategic factors can become unmanageable.
C) the same criticisms found in the SWOT Matrix are replicated.
D) a factor may be listed as both a strength and a weakness.
E) only internal strategic factors are included.
Answer: D
Difficulty: Difficult
Learning Obj.: 6.1: Utilize the SFAS matrix and a SWOT diagram to examine business strategy
AACSB: Analytical thinking
13) If a mission does not provide a common thread for a corporation's businesses, managers
might be unclear about where the company is heading.
Answer: TRUE
Difficulty: Moderate
Learning Obj.: 6.1: Utilize the SFAS matrix and a SWOT diagram to examine business strategy
AACSB: Application of knowledge
15) SWOT is an acronym that stands for Strategy, Weaknesses, Opportunities, and Threats.
Answer: FALSE
Difficulty: Easy
Learning Obj.: 6.1: Utilize the SFAS matrix and a SWOT diagram to examine business strategy
AACSB: Application of knowledge
16) Populating a SWOT chart, by itself, is just the start of a strategic analysis.
Answer: TRUE
Difficulty: Moderate
Learning Obj.: 6.1: Utilize the SFAS matrix and a SWOT diagram to examine business strategy
AACSB: Analytical thinking
17) The goal of strategy is to find an extremely favorable niche so well suited to the firm's
internal and external environment that other corporations are not likely to challenge or dislodge
it.
Answer: TRUE
Difficulty: Moderate
Learning Obj.: 6.1: Utilize the SFAS matrix and a SWOT diagram to examine business strategy
AACSB: Analytical thinking
4
Copyright © 2018 Pearson Education, Inc.
18) The first firm through a strategic window can occupy an extremely favorable niche and
discourage competition (if the firm has the required internal strengths).
Answer: TRUE
Difficulty: Moderate
Learning Obj.: 6.1: Utilize the SFAS matrix and a SWOT diagram to examine business strategy
AACSB: Analytical thinking
19) One company that has successfully found a propitious niche (extremely favorable niche) is
Frank J. Zamboni & Company, the manufacturer of the machines that smooth the ice at ice
skating rinks.
Answer: TRUE
Difficulty: Difficult
Learning Obj.: 6.1: Utilize the SFAS matrix and a SWOT diagram to examine business strategy
AACSB: Analytical thinking
21) The SFAS Matrix summarizes an organization's strategic factors by combining the external
factors from the IFAS Table with the internal factors from the EFAS Table.
Answer: TRUE
Difficulty: Difficult
Learning Obj.: 6.1: Utilize the SFAS matrix and a SWOT diagram to examine business strategy
AACSB: Application of knowledge
22) What is a propitious niche? Provide an example of a firm that has been able to occupy a
propitious niche successfully.
Answer: A propitious niche is an extremely favorable niche that is so well suited to the firm's
competitive advantages that other corporations are not likely to challenge or dislodge it. A niche
is propitious to the extent that it currently is just large enough for one firm to satisfy demand.
After a firm has found and filled that niche, it is not worth a potential competitor's time or money
to also go after the same niche.
One company that has successfully found a propitious niche is Frank J. Zamboni & Company,
the manufacturer of the machines that smooth the ice at ice skating rinks. Zamboni was the first
company through this strategic window. Before the machine was invented, people had to clean
and scrape the ice by hand to prepare the surface for skating. So long as Zamboni's company can
produce the machines in the quantity and quality desired at a reasonable price, it's not worth
another company's effort to go after Frank J. Zamboni's propitious niche.
Difficulty: Difficult
Learning Obj.: 6.1: Utilize the SFAS matrix and a SWOT diagram to examine business strategy
AACSB: Application of knowledge
5
Copyright © 2018 Pearson Education, Inc.
23) Which of the following is true of an organization's mission statement?
A) should be crafted late in the strategic implementation stage
B) articulates how the organization will take advantage of opportunities by overcoming
weaknesses
C) does not have to be unique to the organization
D) should be short so every employee can remember it
E) does not provide direction for employees, but rather informs outsiders of what the
organization does
Answer: D
Difficulty: Difficult
Learning Obj.: 6.2: Develop a mission statement that addresses the five elements of good design
AACSB: Analytical thinking
24) An effective mission statement not only needs to be specific to that organization; it must
enable a common thread to highlight and focus the energy of everyone in the organization in the
direction that the top management team believes is best for the business.
Answer: TRUE
Difficulty: Moderate
Learning Obj.: 6.2: Develop a mission statement that addresses the five elements of good design
AACSB: Application of knowledge
25) One of the first steps in good strategy design should include crafting the mission statement
for the organization.
Answer: TRUE
Difficulty: Easy
Learning Obj.: 6.2: Develop a mission statement that addresses the five elements of good design
AACSB: Application of knowledge
6
Copyright © 2018 Pearson Education, Inc.
27) Which strategy raises the questions of whether to compete on the basis of lower cost or
differentiation and whether to compete for the biggest market or a niche market?
A) business
B) corporate
C) competitive
D) functional
E) focus
Answer: C
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
7
Copyright © 2018 Pearson Education, Inc.
30) Which of the following is not cited as one of the questions that development of a competitive
strategy should raise?
A) Should we compete on the basis of lower cost?
B) Should we compete head-to-head with major competitors?
C) Should we differentiate our products or services on some basis other than cost?
D) Should we compete by garnering political support of influential leaders?
E) Should we compete in a niche market that we can satisfy which is superior to that of the
competition?
Answer: D
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
31) According to Porter, the generic competitive strategy that reflects the ability of the
corporation or its business unit to design, produce, and market a comparable product more
efficiently than its competitors is called
A) competitive scope.
B) differentiation.
C) cost leadership.
D) diversification.
E) focus.
Answer: C
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
32) What are the three generic competitive strategies that Porter promotes as the means for
outperforming other corporations in a particular industry?
A) competitive scope, differentiation, and focus
B) diversification, concentration, and competitive scope
C) cost, competitive scope, and focus
D) concentration, cost leadership, and differentiation
E) cost leadership, differentiation, and focus
Answer: E
Difficulty: Easy
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
8
Copyright © 2018 Pearson Education, Inc.
33) According to Porter, the generic competitive strategy that reflects the ability to provide
unique and superior value to the buyer in terms of product quality, special features, or after-sale
service is called
A) competitive scope.
B) differentiation.
C) focus.
D) diversification.
E) cost leadership.
Answer: B
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
34) According to Porter, the term that applies to the breadth of a company's or business unit's
target market is called
A) competitive scope.
B) differentiation.
C) focus.
D) diversification.
E) cost leadership.
Answer: A
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
9
Copyright © 2018 Pearson Education, Inc.
36) Apple is an example of a company following which of Porter's generic competitive
strategies?
A) cost leadership
B) differentiation
C) cost focus
D) competitive scope
E) diversification
Answer: B
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
37) Which of Porter's competitive strategies recommends that a company emphasize a particular
buyer group or geographic market and attempts to seek a cost advantage in its targeted segment?
A) differentiation
B) cost leadership
C) differentiation focus
D) competitive advantage
E) cost focus
Answer: E
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
38) In manufacturing toilet paper for grocery store chains (and avoiding competing directly
against Charmin), Potlach has followed which of Porter's generic competitive strategies?
A) differentiation
B) cost leadership
C) differentiation focus
D) competitive advantage
E) cost focus
Answer: E
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
10
Copyright © 2018 Pearson Education, Inc.
39) Orphagenix, a small biotech firm, avoids head-to-head competition with large
pharmaceutical companies by developing orphan drugs to target diseases that affect fewer than
200,000 people. This is an example of which of Porter's generic strategies?
A) differentiation
B) cost leadership
C) differentiation focus
D) competitive advantage
E) cost focus
Answer: C
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
41) When a company is concerned that the higher price it charges for its higher quality is too far
above the price of the competition, the company is likely addressing a risk of following which
competitive strategy?
A) cost leadership
B) focus
C) stuck-in-the-middle
D) differentiation
E) competitive scope
Answer: D
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
11
Copyright © 2018 Pearson Education, Inc.
42) Which of the following is not one of the risks of a cost leadership strategy?
A) The technology that the organization has been using changes.
B) Pricing for higher quality that is too far above the price of the competition.
C) Competitors can achieve viable imitations.
D) Other bases for cost leadership erode.
E) Proximity in differentiation is lost.
Answer: B
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
43) Which strategy is a firm following if it provides a unique and superior value in a narrow
market?
A) differentiation focus
B) cost leadership
C) differentiation
D) cost focus
E) stuck in the middle
Answer: A
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
12
Copyright © 2018 Pearson Education, Inc.
46) Morgan Motor Car Company manufactures classic British sports cars. Which of Porter's
strategies is this company following?
A) differentiation focus
B) cost leadership
C) stuck in the middle
D) differentiation
E) cost focus
Answer: A
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
47) Walt Disney Company competes successfully in the entertainment industry using which of
Porter's competitive strategies?
A) differentiation focus
B) stuck in the middle
C) cost leadership
D) differentiation
E) cost focus
Answer: D
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
48) The focus strategies will likely predominate when many small- and medium-sized local
companies compete for relatively small shares of the total market in a(n)
A) united industry.
B) fragmented industry.
C) consolidated industry.
D) isolated industry.
E) integrated industry.
Answer: B
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
13
Copyright © 2018 Pearson Education, Inc.
49) As an industry matures while overcoming fragmentation and becomes dominated by a small
number of large companies, it tends to become a(n)
A) united industry.
B) fragmented industry.
C) consolidated industry.
D) isolated industry.
E) integrated industry.
Answer: C
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
14
Copyright © 2018 Pearson Education, Inc.
53) The last stage of a hypercompetitive industry is reached when the remaining large global
competitors
A) raise entry barriers.
B) move into untapped markets.
C) attack the strongholds of other firms.
D) compete on cost and quality.
E) work their way to a situation of perfect competition in which no one has any advantage and
profits are minimal.
Answer: E
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
54) According to D'Aveni's book, Hypercompetition, which of the following statements is true?
A) Except for a few stable industries, strategy initiatives do not provide sustainable competitive
advantage.
B) Hypercompetition is rare.
C) It is enough to gain competitive advantage by being the lowest cost competitor.
D) The theory of hypercompetition is not supported by any research.
E) The American home appliance industry was immune to hypercompetition.
Answer: A
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
55) Which of Porter's broad mass market competitive strategies requires tight cost control,
frequent detailed control reports, and cost minimization in areas like R&D, service and
advertising?
A) focus
B) differentiation
C) cost leadership
D) focus differentiation
E) concentration
Answer: C
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
15
Copyright © 2018 Pearson Education, Inc.
56) Research suggests that a differentiation strategy is more likely to generate higher profits than
a lower cost strategy because differentiation creates
A) a better entry barrier.
B) a better exit barrier.
C) a better niche market.
D) a more sustainable competitive advantage.
E) no clear long-term strategy.
Answer: A
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
57) Differentiation is a viable strategy for earning above-average returns in a specific business
because the resulting increased value to the customer
A) lowers costs.
B) lowers price sensitivity.
C) lowers customer loyalty.
D) lowers market share.
E) lowers entry barriers.
Answer: B
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
16
Copyright © 2018 Pearson Education, Inc.
60) Strict targets to improve efficiency are likely to be found in organizations following which of
Porter's generic competitive strategies?
A) cost leadership
B) differentiation
C) stuck in the middle
D) differentiation focus
E) cooperative
Answer: A
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
61) According to Barney, under which condition would tacit collusion most likely be successful?
A) There is a large number of identifiable competitors.
B) Costs vary among firms.
C) One firm tends to act as the price leader.
D) Sales are characterized by a low frequency of large orders.
E) There are low barriers to entry in the industry.
Answer: C
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
62) When a company following a differentiation strategy ensures that the higher price it charges
for its higher quality is not priced too far above the price of the competition, the company is
using the process of
A) low-cost differentiation.
B) cost leadership.
C) cost proximity.
D) basic differentiation.
E) price fixing.
Answer: C
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
63) When firms follow each other's lead to reduce the level of competition such as GE and
Westinghouse did in steam turbines, it is referred to as
A) explicit collusion.
B) a strategic alliance.
C) a mutual service consortium.
D) conscious parallelism.
E) partnering.
Answer: D
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
17
Copyright © 2018 Pearson Education, Inc.
64) A secret salary cap was the contention in a 2012 collusion lawsuit filed against
A) KFC.
B) The National Football League.
C) GE.
D) Major League Baseball.
E) ESPN.
Answer: B
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
66) Collusion
A) may be explicit or tacit.
B) may be tacit and therefore legal.
C) is rarely practiced by competing firms.
D) cannot occur without direct communication among firms.
E) is a popular competitive strategy.
Answer: A
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
67) The active cooperation of firms within an industry to reduce output and raise prices to get
around the normal law of supply and demand is referred to as
A) a strategic alliance.
B) collusion.
C) a strategic roll up.
D) a merger.
E) licensing.
Answer: B
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
18
Copyright © 2018 Pearson Education, Inc.
68) The two general types of cooperative strategies are
A) competitive and functional.
B) collusion and competitive.
C) strategic alliances and collusion.
D) strategic alliances and competitive.
E) competitive and collusive alliances.
Answer: C
Difficulty: Easy
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
69) If it is to be successful, Porter advises that a division possess strong marketing abilities,
product engineering, a creative flair, strong capability in basic research and a corporate
reputation for quality or technological leadership, for which one of the following generic
competitive strategies?
A) focus
B) differentiation
C) overall cost leadership
D) vertical growth
E) concentration
Answer: B
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
70) Product engineering, creative flair, and strong cooperation from channels are commonly
required skills and resources for which of Porter's generic strategies?
A) cost leadership
B) differentiation
C) cost leadership focus
D) differentiation focus
E) collusion
Answer: B
Difficulty: Easy
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Reflective thinking
71) Intense supervision of labor, sustained capital investment and access to capital are commonly
required skills and resources for which of Porter's generic competitive strategies?
A) cost leadership
B) differentiation
C) cost leadership focus
D) differentiation focus
E) collusion
Answer: A
Difficulty: Easy
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Reflective thinking
19
Copyright © 2018 Pearson Education, Inc.
72) Amenities to attract highly skilled labor, scientists, or creative people are a common
organizational requirement for which of Porter's generic competitive strategies?
A) cost leadership
B) differentiation
C) cost leadership focus
D) differentiation focus
E) collusion
Answer: B
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Reflective thinking
73) Incentives based on meeting strict quantitative targets are a common organizational
requirement for which of Porter's generic competitive strategies?
A) cost leadership
B) differentiation
C) cost leadership focus
D) differentiation focus
E) collusion
Answer: A
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Reflective thinking
74) One skill required of the cost leadership strategy is a strong marketing ability.
Answer: FALSE
Difficulty: Easy
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
75) Business strategy focuses on improving the competitive position of a company's or business
unit's products or services within the specific industry or market segment that the company or
business unit serves.
Answer: TRUE
Difficulty: Easy
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
76) Cost leadership is the ability of a company or business unit to design, produce, and market a
comparable product more efficiently than its competitors.
Answer: TRUE
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
20
Copyright © 2018 Pearson Education, Inc.
77) A cost leader's lower costs allow it to continue to earn profits during times of heavy
competition.
Answer: TRUE
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
78) An example of a company following a cost focus strategy is Potlach Corporation, which
makes house brands of toilet paper for Safeway and other grocery store chains.
Answer: TRUE
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
79) One risk of a cost leadership strategy is that the technology for production or of products
may change.
Answer: TRUE
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
80) An example of a company that was "stuck in the middle" was K-Mart as the company tried
to imitate both Walmart's low-cost strategy and Target's differentiation strategy.
Answer: TRUE
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
81) Although Porter agrees that it is possible for a company to achieve low cost and
differentiation simultaneously, he suggests that no company has been able to achieve this.
Answer: FALSE
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
83) The strategic rollup was developed in the mid-1990s as an efficient way to quickly
consolidate a fragmented industry with the resulting large firm creating economies of scale.
Answer: TRUE
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
21
Copyright © 2018 Pearson Education, Inc.
84) Rollups are not synonymous with traditional mergers and acquisitions.
Answer: TRUE
Difficulty: Easy
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
85) One danger of D'Aveni's concept of hypercompetition is that it may lead to an overemphasis
on short-term tactics over long-term strategy.
Answer: TRUE
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
86) The ability to market a comparable product or service more efficiently than competitors is
the one skill not required in a cost leadership strategy.
Answer: FALSE
Difficulty: Easy
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
87) Tight cost control is an organizational requirement for a cost leadership strategy.
Answer: TRUE
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
88) The only way to gain competitive advantage within an industry is to use a competitive
strategy.
Answer: FALSE
Difficulty: Easy
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Analytical thinking
89) Those companies using cooperative strategies are generally not able to gain a competitive
advantage.
Answer: FALSE
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
90) The two general types of cooperative strategies are collusion and strategic alliances.
Answer: TRUE
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
22
Copyright © 2018 Pearson Education, Inc.
91) In tacit collusion, there is no direct communication among competing firms.
Answer: TRUE
Difficulty: Difficult
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
92) Collusion is the active cooperation of firms within an industry to reduce output and raise
prices in order to get around the normal economic law of supply and demand.
Answer: TRUE
Difficulty: Moderate
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
94) Discuss competitive strategy differences between a fragmented and a consolidated industry.
Answer: In a fragmented industry, there are many small- and medium-sized local companies
competing for relatively small shares of the total market. Focus strategies will likely predominate
in a fragmented industry. Fragmented industries are typical for products in the early stages of
their life cycle. If few economies are to be gained through size, no large firms will emerge and
entry barriers will be low—allowing a stream of new entrants into the industry.
23
Copyright © 2018 Pearson Education, Inc.
95) What is the impact of hypercompetition on competitive advantage?
Answer: Hypercompetition reflects the increasing difficulty of sustaining a competitive
advantage over time. As a result of this erosion of competitive advantage, companies must
constantly work to improve their advantage. Firms must constantly seek new ways to lower costs
and add value to their products and services.
Difficulty: Easy
Learning Obj.: 6.3: Explain the competitive and cooperative strategies available to corporations
AACSB: Application of knowledge
98) The "cell" chip created by IBM, Sony Electronics, and Toshiba was a result of pooling their
resources in a
A) joint venture.
B) licensing arrangement.
C) value-chain partnership.
D) mutual service consortium.
E) competitive advantage.
Answer: D
Difficulty: Difficult
Learning Obj.: 6.4: Identify the types of strategic alliances
AACSB: Application of knowledge
24
Copyright © 2018 Pearson Education, Inc.
99) Disadvantages of joint ventures include all of the following EXCEPT
A) loss of control.
B) lower profits.
C) probability of conflicts with partners.
D) likely transfer of technological advantage to the partner.
E) mutual dependence.
Answer: E
Difficulty: Moderate
Learning Obj.: 6.4: Identify the types of strategic alliances
AACSB: Application of knowledge
100) When Facebook partnered with nine news organizations to allow the news organizations
(including powerhouses like the New York Times and NBC News) to post stories on the
Facebook site, they engaged in
A) a joint venture.
B) a licensing arrangement.
C) a value-chain partnership.
D) a mutual service consortium.
E) a competitive advantage.
Answer: C
Difficulty: Difficult
Learning Obj.: 6.4: Identify the types of strategic alliances
AACSB: Analytical thinking
102) Which of the following is not a reason companies or business units may form a strategic
alliance?
A) to obtain access to specific markets
B) to reduce financial risk
C) to reduce political risk
D) to set prices in the industry
E) to learn new capabilities
Answer: D
Difficulty: Moderate
Learning Obj.: 6.4: Identify the types of strategic alliances
AACSB: Analytical thinking
25
Copyright © 2018 Pearson Education, Inc.
103) The kind of strategic alliance in which there is a partnership of similar companies in similar
industries who pool their resources to gain a benefit that is too expensive to develop alone is the
A) joint venture.
B) licensing agreement.
C) value-chain partnership.
D) mutual service consortia.
E) holding company.
Answer: D
Difficulty: Moderate
Learning Obj.: 6.4: Identify the types of strategic alliances
AACSB: Application of knowledge
104) Which strategy has been used successfully by Yum! Brands to establish KFC and Pizza Hut
restaurants across the globe?
A) joint venture
B) licensing arrangement
C) strategic alliance
D) marketing strategy
E) value-chain partnership
Answer: B
Difficulty: Difficult
Learning Obj.: 6.4: Identify the types of strategic alliances
AACSB: Application of knowledge
105) The kind of strategic alliance in which a company forms a strong and close long-term
relationship for mutual advantage with a key supplier or distributor is the
A) joint venture.
B) licensing agreement.
C) value-chain partnership.
D) mutual service consortia.
E) holding company.
Answer: C
Difficulty: Moderate
Learning Obj.: 6.4: Identify the types of strategic alliances
AACSB: Application of knowledge
26
Copyright © 2018 Pearson Education, Inc.
106) Which of the following is not considered a strategic alliance success factor?
A) Have a clear strategic purpose.
B) Operate with short-term time horizon.
C) Agree on an exit strategy for when the partners' objectives are achieved or the partnership
fails.
D) Minimize conflicts among the partners by clarifying the objectives.
E) Identify likely partnering risks and deal with them when the alliance is formed.
Answer: B
Difficulty: Moderate
Learning Obj.: 6.4: Identify the types of strategic alliances
AACSB: Analytical thinking
107) Alliances do not take less financial resources than do acquisitions or going it alone and are
not easier to exit if necessary.
Answer: FALSE
Difficulty: Moderate
Learning Obj.: 6.4: Identify the types of strategic alliances
AACSB: Analytical thinking
108) Too much partnering experience with the same strategic partners generates diminishing
returns over time and leads to reduced performance.
Answer: TRUE
Difficulty: Difficult
Learning Obj.: 6.4: Identify the types of strategic alliances
AACSB: Analytical thinking
109) A licensing arrangement is an agreement in which the licensing firm grants rights to another
firm in another country or market to produce and/or sell a product.
Answer: TRUE
Difficulty: Easy
Learning Obj.: 6.4: Identify the types of strategic alliances
AACSB: Application of knowledge
110) A value chain partnership is a loose alliance with several distributors for the short term.
Answer: FALSE
Difficulty: Moderate
Learning Obj.: 6.4: Identify the types of strategic alliances
AACSB: Application of knowledge
111) One success factor to a strategic alliance is the ability to identify likely partnering risks and
deal with them when the alliance is formed.
Answer: TRUE
Difficulty: Moderate
Learning Obj.: 6.4: Identify the types of strategic alliances
AACSB: Analytical thinking
27
Copyright © 2018 Pearson Education, Inc.
112) Discuss the reasons a firm may form a strategic alliance.
Answer: A strategic alliance is a long-term cooperative arrangement between two or more
independent firms or business units that engage in business activities for mutual economic gain.
A firm may form a strategic alliance to obtain or learn new capabilities, to obtain access to
specific markets, to reduce financial risk, or to reduce political risk.
Difficulty: Moderate
Learning Obj.: 6.4: Identify the types of strategic alliances
AACSB: Application of knowledge
113) Discuss the types of alliances that businesses can engage in?
Answer: The types of alliances that businesses can engage in include a mutual service
consortium, a joint venture, a licensing arrangement, and a value-chain partnership. A mutual
service consortium is a partnership of similar companies in similar industries that pool their
resources to gain a benefit that is too expensive to develop alone. A joint venture is a
"cooperative business activity, formed by two or more separate organizations for strategic
purposes, that creates an independent business entity and allocates ownership, operational
responsibilities, and financial risks and rewards to each member, while preserving their separate
identity/autonomy." A licensing arrangement is an agreement in which the licensing firm grants
rights to another firm in another country or market to produce and/or sell a product. The licensee
pays compensation to the licensing firm in return for technical expertise. A value-chain
partnership is a strong and close alliance in which one company or unit forms a long-term
arrangement with a key supplier or distributor for mutual advantage.
Difficulty: Difficult
Learning Obj.: 6.4: Identify the types of strategic alliances
AACSB: Application of knowledge
28
Copyright © 2018 Pearson Education, Inc.
Another random document with
no related content on Scribd:
“Still, we must remember how singularly, of late years, the knowledge of the
introduction of cholera by persons coming from infected districts has increased, and
how very striking are the instances of this kind already recorded in several works on
influenza.
“In some cases, again, isolation or seclusion of a community, as in prisons, has given
immunity; or at least that community has not been attacked.”
The great rapidity of spread has caused even in 1918 some temporary doubt as to the
contagiousness of the disease. Thus, Zinsser wrote:
“The opinion of direct and indirect transmission from man to man is also well
supported by a detailed study of the epidemiology of individual outbreaks. In our own
experience with epidemics such as those at Chaumont, Baccarat and other places, the
suddenness with which the malady attacked large numbers of people at almost one and
the same time, caused me at first to be exceedingly skeptical of accepting transmission
by contact as the only means of conveyance. We considered food and insect transmission
as possibilities, and tried our best to find grounds for involving such agencies. But in
every case we were forced to return to the conclusion that direct and indirect contact
between men came nearest to doing justice to all observed facts.”
There have been many examples reported from personal experience to show that
influenza is transmitted from man to man. Two objections, however, have had to be met,
before this view was generally accepted. First, it has been claimed by some that the
disease spread more rapidly from an assumed focus than individuals could travel, and
second, that instances were on record of cases occurring spontaneously in isolated
communities. Yet a third argument formerly raised against the contagious character of
the disease was the claim that it broke out in mass attacks, that large numbers became ill
on the same day without the occurrence of isolated antecedent cases. The splendid work
of epidemiologists following the 1889 epidemic appears to have answered all of these
objections. Many, such as Leichtenstern, have gone into great detail on this subject. In
fact, at that time this was the question of greatest importance. Today we assume the
correctness of the hypothesis, and pass on to consideration of other subjects of more
recent development. We will, therefore, review very hurriedly some of the evidence
quoted to prove that influenza is transmitted only from man to man and only by human
intercourse.
Isolated places.—Has it ever been shown that individuals completely isolated from
communication with communities where influenza is present have, during an epidemic,
developed the disease? Leichtenstern, after a comprehensive review, concludes as
follows: “We have not a single example on record where influenza has attacked
individuals in completely isolated localities, as on mountain tops and mountain passes.
Study of this has been undertaken in Switzerland by F. Schmid. The same has been true
of ships at sea, as has been shown chiefly from the English Marine Reports. There have
been reports of influenza occurring in mid-ocean and particularly in the earlier
epidemics, but the information has been insufficient.”
Parkes at even an earlier period observed: “I cannot but consider that we require
better evidence of ships being attacked in mid-ocean. In some of the quoted instances
the ships had been at a port either known to be infected or in which influenza was really
present, although it had not become epidemic. As we are ignorant of the exact period of
incubation some men may have been infected before sailing.”
Critical investigation into stories of spontaneous infection in isolated localities such as
ships at sea and island lighthouses will quite invariably demonstrate that these popular
reports have been distortions of the actual facts. One or two examples will suffice.
Abbott records an example: “An impression having gained some credence that influenza
had appeared on board the squadron of naval vessels which sailed from Boston in
December, 1889, while on their course across the Atlantic and before their arrival in
Europe, a letter was addressed by the writer to the Bureau of Medicine and Surgery of
the United States Navy for information upon this point, to which a reply was received, as
follows:
“The ‘Chicago,’ ‘Boston,’ ‘Atlanta’ and ‘Yorktown’ left Boston December 7, 1889, for
Lisbon, Portugal. The first three arrived at Lisbon on December 21st without having
touched at any port en route. The ‘Yorktown’ arrived at that port December 23d, having,
stopped about twenty-four hours at Fayal, Azores.... Influenza first appeared on the
‘Chicago’ December 23d, on the ‘Boston’ December 28th, on the ‘Atlanta’ December
30th and on the ‘Yorktown’ December 28th.
“Influenza was prevailing in Lisbon at the date of arrival of the squadron.”
In March, 1920, the author was notified of a somewhat similar story which he
undertook to trace. The results show well the inaccuracy of verbal transmission through
several individuals. A letter was first sent to the Quarantine Officer at Portland, Maine:
“It has been reported to us that in a lighthouse just outside of Portland, Maine, there has
been a rather interesting prank played by influenza. We are told that three men and one
woman live in the lighthouse; that during the 1918 influenza epidemic the woman
contracted the disease while none of the men became sick, and that in the present
epidemic all three of the men became sick with the disease and the woman remained
well. It was claimed that they had had no communication with the mainland for some
time before the men became ill,” etc.
The reply was as follows: “I have inquired of the Light House Inspector’s office in
Portland and they know of no stations to which the terms of your inquiry would apply.
“At the Boon Island station, there are three keepers with families. At the Half Way
Rock station, there are three keepers but no woman. The Inspector does not seem to
know of any station where there are three men and one woman.”
A second letter, sent to the Inspector of Lighthouses at Portland brought corroborative
information:
“The Boon Island Light Station was stricken by this epidemic in the following manner:
The keeper, his wife and five children were all stricken, the keeper himself having had
the hardest battle, having apparently been subject to same while ashore in Portsmouth,
N. H. after provisions, supplies, etc. The 2d assistant’s wife and two children were also
stricken, but the 2d assistant, himself, and the 1st assistant keeper did not contract the
malady in spite of the fact that they were all confined on a small island working together
at the station.
“During the year 1920 none of the keepers or their families, consisting of thirteen in
number, were affected. The Halfway Rock Light Station where three keepers are
employed did not contract this malady either in the years 1918 or 1920.
“For your information I might add that during the inspection trip in the months of
January, February and March, 1920, all of the light stations in this district were visited,
and it was found that they were all enjoying good health and had not been visited by the
epidemic, with the possible exception of three stations which are located either on the
mainland or close to where the keeper or his family were able to visit the nearby cities or
towns.”
Although it has not been shown that completely isolated places have been visited by
the disease, there is abundant evidence that such places have remained influenza free as
long as the isolation has remained complete. Islands and lighthouses, which have not
been in communication with the mainland, individuals living isolated on mountain tops,
and ships at sea remained free from influenza even in the presence of a pandemic, as
long as they did not come into communication with individuals sick with the disease.
The following places remained free from influenza throughout the 1889 epidemic: the
Isle of Man, several of the islands of the West Indies, particularly the Bahamas, Granada
and St. Lucia, also the British Honduras, British Guiana, and the Seychelle Islands.
Even in 1918, when the paths of commerce reached nearly every portion of the world,
we have examples of relative immunity of isolated places. Thus we know that the
Esquimaux were attacked late in the course of the pandemic, and we have the statement
of Barthélemy who traveled in 1919 to some of the oasis towns of the Sahara Desert, and
there discovered that there had not only been no influenza up to that time, but also that
they had not even heard of the pandemic.
Another type of isolated place is the closed institution. As early as 1709, Lancisi
remarked that the prisons of the Inquisition in Rome remained free from influenza.
Twenty-one prisons in Germany in 1889–90 remained entirely free from the disease.
This was true of 39 prisons in England, some of which were in cities where the epidemic
was most extensive. Linroth, who observed this same phenomenon in Sweden, makes
the wise remark that, “the influenza conquers more easily the space of 500 to 1,000
kilometers than it does the small barrier made by a prison wall.” A convent in
Charlottenburg housing one hundred women remained entirely free during the 1889–90
epidemic.
As a rule institutions of this sort have been unable to maintain a complete quarantine
throughout the period of an epidemic, and the relative immunity has been demonstrated
more in late invasions, at a time when the restrictions have become somewhat lax. Thus,
in 1918, Winslow and Rogers, report that in an orphan asylum in New Haven,
Connecticut, which had completely escaped during the month of October when the
epidemic was at its height, one of the Sisters and the priest in charge came down with
influenza about December 15th. By the 27th of December 127 cases had occurred in the
institution within twenty-four hours, and by January 7th there had been 424 cases, with
seven deaths out of a total population of 464. The probable source of the sudden
outbreak of December 27th seems to have been the Sister first affected who, when
convalescent, resumed her duties in the kitchen, which included the inspection and
handling of the milk given out to the children.
Crowd gatherings.—Yet another phenomenon which would lead us to conclude that
human intercourse is the most potent factor in the transmission of influenza is the fact
that there is frequently a high increase in the influenza rate following crowd gatherings.
Parkes observed long ago that persons in overcrowded habitations, particularly in some
epidemics, suffered especially, and several instances are on record of a large school or a
barracks being first attacked and the disease prevailing there for some days, before it
became prevalent in the towns around.
In England, the weekly market played an important role in the spread of the disease in
1889. One frequently saw such reports as that: “The first case of influenza was a man
who went to London daily.” Or, “All the earliest cases were men going to London daily,
while their wives and families were later affected.”
In the epidemics at San Quentin Prison, it was noted that apices of incidence usually
occurred on Tuesday and Wednesday. During the first epidemic it was these days of the
second and third weeks. Stanley sees a direct connection between this fact and the fact
that every Sunday morning large groups of the men were crowded together in a
comparatively small auditorium where they saw moving pictures. On Sunday, October
20th, they sought to eliminate this source of spread by having a band concert in the open
air, but the prisoners crowded around the band and were loud in their cheers, and on the
following day there was a large increase in hospital admissions.
On November 24th after the second epidemic had apparently ceased the picture
shows were again started after having been closed for over six weeks. The following
Tuesday and Wednesday twenty-four well defined new cases were admitted to the
hospital. On Thanksgiving Day there was a field meet between the various departments
of the prison. About 200 prisoners took active part, while 1,600 prisoners were
spectators. The meet was held in the open air, but the prisoners were closely packed and
they cheered and yelled. For the three days following this celebration there were 9, 5 and
8 patients admitted respectively.
In discussing the recrudescence of influenza in Boston in November and December,
Woodward remarks as follows:
“Whether or not it may be more than a succession of coincidences it is certainly of
interest to note that the November outbreak of influenza showed itself three days after
the Peace Day celebration on November 12th, when the streets, eating places and public
conveyances were jammed with crowds; that the December epidemic began to manifest
itself after the Thanksgiving holiday, with its family re-unions and visiting; and that
reported cases mounted rapidly during the period of Christmas shopping, reaching a
maximum a week after the holiday.” That this may have been a coincidence is indicated
by the fact that, according to reports by Pearl and others this was not consistently true in
other large cities.
Dr. Meredith Davies records the case of a hostel in Wales accommodating 200
students. Infection was introduced on October 19th on the occasion of a dance attended
by some students from an infected institution in the neighborhood. Four cases occurred
on the 20th and within the short space of five days seventy-nine students out of the 200
were attacked.
Parsons found numerous similar examples in the epidemic of 1889. In 1918 it was
frequently observed that among American Soldiers in France, those troops quartered in
barracks suffered a much more rapid spread of the disease than those billetted out
among the houses of the towns.
Mass attack.—Another argument formerly raised against the contagious character
was the claim that it broke out in mass attack, and large numbers became ill on the same
day without the occurrence of isolated antecedent cases. The first cases of such epidemic
diseases as the plague and small pox became a matter of record because of the
accompanying high mortality, while in influenza, with its relatively low death rate the
record usually begins only after a comparatively large mass of individuals have been
attacked.
Watson in 1847 observed as follows: “Although the general descent of the malady is,
as I have said, very sudden and diffused, scattered cases of it, like the first droppings of a
thunder shower, have usually been remembered as having preceded it. The disorder is
most violent at the commencement of the visitation; then its severity abates; and the
epidemic is mostly over in about six weeks. Yet the morbific influence would seem to
have a longer duration. In a given place nearly all the inhabitants who are susceptible of
the distemper suffer it within that period, or become proof against its power. But
strangers, who, after that period, arrive from uninfected places have not, apparently, the
same immunity.”
Parkes in 1876 observed that, “When the disease enters a town it has occasionally
attacked numbers of the inhabitants almost simultaneously. But more frequently its
course is somewhat slower; it attacks a few families first and then in a few days rapidly
spreads; the accounts of thousands of persons being at once attacked at the onset of the
disease are chiefly taken from the older records, in which the suddenness of the
outbreak is exaggerated. Frequently, perhaps always, in a great city the outbreak is made
up by a number of localized attacks, certain streets or districts being more affected than
others, or being for a time solely affected, and in this way it successively passes to
different parts of the city. It has generally occurred in a great city before appearing in the
smaller towns and villages round it and sometimes these towns, though in the
neighborhood, have not been invaded for some weeks.
“In some cases and perhaps a large number, it breaks out after persons ill with
influenza have arrived from infected places.
“The decline in any great town is less rapid than its rise, and usually occupies from
four to six weeks, or sometimes longer.”
Detailed studies of the Munich epidemic of 1889 and numerous similar studies of the
recent epidemic, which will be referred to later, have shown a period of two or three
weeks of steadily increasing numbers of cases before the height of the epidemic was
reached.
Droplet infection and spread through inanimate objects.—The actual mode of spread
of the virus of influenza from one individual to another is unknown. The more generally
accepted explanation is that the infecting agent leaves the body through the respiratory
tract, usually in the spray of coughing or talking; contagion is by droplet infection, as is
sometimes the case in other respiratory infections. Thorne and others have called
attention to the capillary congestion of the conjunctivae very early in the disease. They
suggest that possibly the mucous membrane of the eye is the site of infection.
There has recently been considerable discussion concerning the spread of influenza
through inanimate objects.
Leichtenstern reviews the reports of 1889–93 in which influenza was supposed to
have been transmitted through wares, merchandise and other inanimate objects. He
concluded that the evidence in all of the cases cited was insufficient for conclusive proof.
Such an example was the supposed importation of the disease in goods sent from Russia
to the Grands Magazins du Louvre at Paris. In one day 100 people became ill and in a
few more 500 were sick with influenza. The explanation was that the germs had been
imported in goods sent from Russia to the store. Detailed investigation showed that this
could not have been the case because no goods had been received from Russia for a
period of three years. Another example is that of one of the two winter caretakers at the
St. Gothard Hospice. One of the two men went down into the valley where he purchased
supplies. Ten days after his return the man who had remained in the Hospice fell ill with
influenza while his comrade remained well. It was stated that influenza was introduced
into Basel by goods shipped to that place from the Magazins du Louvre in Paris. The first
case occurred in a man who had been working at unpacking these goods.
Lynch and Cumming believe that droplet infection plays but a minor role in the
spread of sputum-borne diseases, but that insanitary methods of washing dishes and
eating utensils was the chief cause for the high rates of “sputum-borne” infections both
in army and civilian life in 1918. They found that among 31,000 troops eating from
tableware which was cleaned by kitchen police, the influenza rate was 51 per 1,000,
while among 35,000 eating from mess kits which each individual washed himself the
rate was 252 per 1,000. “Eighty-four per cent. of the cases occurred among those whose
hands were contaminated by washing their own eating utensils.”
Among 17,236 employees of hotels, restaurants and department stores, who ate from
machine washed dishes, there occurred 349 cases of influenza, while among 4,175 who
ate from hand washed dishes there were 429 cases. The rate was but 20 per 1,000 in the
former, while in the latter group it reached 103 per 1,000. Here again the chances of
infection between the two groups were as one is to five.
These authors have records covering 252,186 individuals in scattered institutions in
the United States. Among those eating from machine washed dishes the rate was 108 per
1,000 while those eating from hand washed dishes suffered at the rate of 324 per 1,000.
The ratio was 1 to 3 between the two groups. Seventy-five per cent. of the cases occurred
in that group which ate from dishes not disinfected with boiling water. They do not state
the number of individuals in each of the two groups.
Lynch and Cumming claim that in the act of coughing only a few organisms are
expelled from the mouth, rarely over 1,500, and conclude that transmission by direct
contact through the air route but rarely, if ever, takes place. While about 1,500
organisms are expelled onto the floor by an act of coughing, a sterile glove wiped across
the lips may pick up nearly 2,000,000 organisms. Such organisms may be readily
transferred to inanimate objects which are handled by many people.
Hemolytic streptococci and pneumococci may be isolated with great regularity from
the hands of carriers or patients, from table ware, inanimate objects touched by these
patients, and from floor dust. Diphtheria and tubercle bacilli have been isolated from the
hands and eating utensils of patients. The average count of a large number of restaurant
dishwater specimens was 4,000,000 bacteria per c.c. The temperature of this water
averaged 43° C. and the dishes were practically never scalded. The water was often so
highly polluted, “that the dishes are more highly contaminated after they are washed
than before washing begins. The spoon or fork is often freer from organisms just after
being used by the restaurant patron than when taken from the restaurant’s polluted dish
water.”
Major John S. Billings, epidemiologist at Camp Custer, reported that one of the larger
organizations did not properly observe the regulation requiring that all mess kits and
table equipment be properly sterilized. The disease appeared early and spread unusually
rapidly in this particular organization.
In summarizing the subject of transmission through utensils, we may say that the
evidence is suggestive but inconclusive. It is possible, even probable, that this is one
mode of transmission. That it is the most important has not been proved. Lynch and
Cumming do not take into consideration that the regiments with more sanitary methods
of cleansing the dishes are apt to be those regiments with more sanitary habits
throughout their daily routine. Those restaurants using mechanical dish washers are
usually the cleaner restaurants.
Pontano in Italy is quoted by the Office International d’Hygiène Publique as having
observed in his epidemiological study that there was a constant connection between the
living conditions and the severity of the complications. Notable differences were
observed in neighboring houses according to the hygienic conditions of the various
households.
Healthy carriers and convalescents.—Leichtenstern, who apparently accepted the
Pfeiffer bacillus as the cause of influenza, did not believe that the disease could be
transmitted by healthy carriers. He based this assumption on the statement, made by
Pfeiffer, that the influenza bacillus was only found in acute influenza cases. In the past
few years it has been abundantly shown, however, that the influenza bacillus can and
does exist on the mucous membranes of healthy individuals.
The outbreak in an orphan asylum in New Haven has been previously described.
There the probable source of the sharp outbreak of December 27th seemed to be the
sister who, on convalescence, resumed her duties in the kitchen. There she inspected
and handled the milk served to the children. This suggests the possibility of infection
being propagated by convalescents and by food.
At present we do not know whether or not a patient remains infectious after the acute
symptoms have subsided; we are ignorant as to whether a convalescent patient can
transmit the disease; and we are not certain whether the organism found in healthy
carriers is virulent or not. The information at hand strongly indicates that apparently
healthy individuals may transmit the infection, but the wide distribution of the disease,
with multiple possible sources of infection for each individual, and the relative
insusceptibility of experimentally exposed individuals has made it impossible so far to
answer these questions satisfactorily.
General Manner of Spread in Individual Localities.
Having discussed the mode of propagation of influenza among individuals we will
follow the disease as it attacks one person after another in a community and study the
epidemiologic picture, drawn no longer with the individual as a unit, but with the
community as the unit.
We must here distinguish between a primary epidemic, the first wave of a progressing
pandemic, and the secondary type in which may be grouped those large or small
recurrences which light up for a period of one to three or more years after the primary
wave.
Primary type of epidemic.—One of the first important statistical studies on this
subject was that of P. Friedrich who charted the influenza morbidity in Munich between
the months of December, 1889, and February, 1890. Similar observations have been
made by Parsons, Raats, Linroth, and H. Schmid, following the 1889 epidemic.
Between the occurrence of the first known case of influenza and the time of the first
very definite increase in influenza incidence in a community, which interval may be
termed the invasion period, there is as a rule two weeks. During this period, of course,
more and more cases are occurring, but remain usually sufficiently isolated to attract no
public notice. From this point the epidemic develops very rapidly and reaches its peak,
usually within two or at most three weeks. In another two or three weeks the incidence
has fallen away nearly to normal. The epidemic period comprises from four to six weeks,
or, including the invasion period, an entire duration of six to eight weeks. This is the
picture produced in a community by a primary uncomplicated epidemic of influenza.
Greenwood well describes the salient features of a primary epidemic as “first a rapid and
quasi-symmetrical evolution, and second, a frequency closely concentrated around the
maximum.” In other words the duration is short, the rise to a peak rapid, and the
subsequent fall equally rapid. He showed that in the July and August, 1918 epidemic in
Great Britain nearly 80 per cent. of the total incidence in the localities studied was
grouped within three weeks time. His curve corresponds so well with that of the Munich
epidemic that he is able to superimpose them (Chart I). The rapid rise to a peak, almost
explosive in character, more characteristic of this disease than of any other, is to be
explained by the high degree of invasiveness of the organism, by the short period of
incubation, by the fact that many of the sick continue at their work, thus spreading the
disease, and by the non-immunity of large masses of people, together with the fact that
the transmission of a respiratory infection is accomplished much more easily than is any
other type of infection.
The author holds that the infrequency of immunity is a most important factor in the
production of this type of outbreak. The mode of transmission of influenza is the same
as that of other respiratory diseases. The infectivity is probably no greater than that of
measles, although that indeed is relatively great. The means of transmission are
presumably the same in each. Were we able to develop an immunity for influenza of as
high degree and permanence as we possess against measles, pandemics of influenza
would disappear. We wish to emphasize that the primary type of curve is a phenomenon
not peculiar to influenza, but that under certain circumstances it may be found in other
infectious diseases, and that it would be found more frequently in the other diseases if
the immunity developed against them was of as short duration as it appears to be
against influenza. If, for example, measles were to break out in a large group of
individuals, none of whom had had the disease, the type of curve would be the same. We
will produce evidence supporting our theory under another subject. Of course, other
factors such as short incubation period and unusual opportunities for spread through
mildly ill individuals play a not unimportant role.
CHART I.