8 - Emerging Infectious Diseases 2

Question 1

Echinococcus multilocularis clinical symptoms, transmission

Answer 1

Incubation period up to 15 yrs
Liver lesions
Fatal without therapy

Transmission through food contaminated by canid feces, contact with wild canid feces contaminating domestic animals, infected domestic animals (dogs)

Question 2

E. multilocularis previously found where? Prevalence in NA?

Answer 2

China

Very rare in NA previously (2 cases in 86 years)

Question 3

E. multilocularis first identified by…

Answer 3

vets

Question 4

Prevalence of E multilocularis in Alberta? Edmonton?

Answer 4

33% coyote samples in Alberta

65% coyote samples infected in Edmonton

Question 5

What type of Coyotes carry EM more frequently

Answer 5

Urban coyotes (56%)

More common in younger, unhealthy coyotes (food consumption in young coyotes)

Question 6

Strains of EM in NA

Answer 6

• 3 strains resembling European strain (likely due to dog importation)
• novel ECA strain (unique to Canada)

Question 7

The ECA strain (European Canadian) is more..

Answer 7

virulent than NA historical strains

Question 8

Majority of human cases of EM are in what demographics

Answer 8

Rural = 64%
Urban = 26%
Dog owner = 90%

Question 9

What is likely going in with EM strain?

Answer 9

European strain likely introduced by foxes -> single nucleotide polymorphism -> new ECA strain
ECA more virulent and outcompeting endemic north american strain

Question 10

How is EM a one health issue

Answer 10

• emerging
• pets
• urbanization of wild animals (ecological change)
• international movement

Question 11

Two classes of filovirus

Answer 11

Marburg and Ebola

Question 12

Ebola transmission, reservoir

Answer 12

Person-person transmission (health care workers, body burial)
Bat reservoir

Question 13

Most Ebola outbreaks are where

Answer 13

Central, west Africa

Question 14

Describe the ebola outbreak in guinea

Answer 14

2013: Two year old boy became ill and died
A week later his mother, sister and grandmother died

Grandmother had large funeral with visitors from neighouring villages

Question 15

Describe the Ebola epidemic in Congo

Answer 15

2018
2nd largest in history
In a war zone = challenges to response (distrust of affected pop)
2287 deaths

First time people were vaccinated (~300,000)

Question 16

Effectiveness of Ebola vaccine

Answer 16

Immediate vaccination = no clinical cases

Delayed vaccination = 16 cases

Question 17

What is the ebola vaccine

Answer 17

rVSV-ZEBOV vaccine (ring vaccination)

Question 18

Issues with Ebola

Answer 18

• unpreditable
• potential for global transmission
• cultural practices

Question 19

First Zika outbreak spread where? The second one? Third?

Answer 19

1st: Africa (uganda, nigeria) to south-east asia (malaysia, phillipines)

2nd: SE Asia to French Polynesia, Tonga

3rd (emergence in America):French Polynesia to Brazil

Question 20

When did Zika emerge in the Americas? What was it causing? What happened

Answer 20

Brazil 2015

Causing microcephaly in babies (not seen in other outbreaks)

WHO declared public health emergency of international concern in 2016, huge uptake in cases, then disappeared

Question 21

Modes of infection by Zika virus, infections in patients

Answer 21

Mosquito, sexual, blood transfusion, pregnancy

50-80% Asymptomatic
20-50% mild disease

Question 22

Likelihood of complications in pregnancy due to Zika virus

Answer 22

70-80% fetuses have no infection

20-30% infected
- 4-7% fetal loss
- 5-14% microcephaly (cong zika syn)
- rest asymptomatic

Question 23

Why is Zika now found in the Americas?

Answer 23

Aedes aegypti increasing its range
Increased human pop density and travel

Question 24

Was American Zika really more virulent?

Answer 24

More virulent strain was present in Africa, but unrecognized bc was causing fetal death and not microcephaly