Exam #8: Zoonotic & Vector Borne Bacterial Infections I Flashcards
How is zoonosis prevented & controlled?
1) Avoidance of reservoirs and vectors
2) Eradicate reservoir or vector
3) Proper sanitation
*Note that vaccines are generally not feasible due to low incidence.
List the zoonotic bacteria that are considered bioterrorism agents.
- Anthrax
- Brucellosis
- Meliodosis
- Tularemia
- Plague
List the characteristics of Anthrax.
Anthrax is caused by Bacillus anthracis
- Gram positive rods
- Aerobes
- Spore-forming (remain viable for decades)– green spore
- Appear in long chains with squared ends
“Boxcar” in culture
What virulence factors is associated with Anthrax?
- Protein capsule, which is unique–others are polysaccharide
- Protective antigen (like B) with either Lethal toxin or Edema toxin associated with it
What is the function of protective antigen?
Acts like B-subunit, binding
What is the mechanism of Lethal Toxin?
Disrupts normal cellular signaling events, leading to cell death, inflammation, and tissue damage
What is the mechanism of Edema Toxin?
Activates adenylate cyclase, increases cAMP, changes osmotic gradients, and ultimately leads to edema
Describe the pathenogenesis of Anthrax.
- Spores are inoculated, ingested, or inhaled
- Spores germinate into cells that produce toxin
- Protective antigen binds cellular receptors on host tissues and cells
- Protective antigen is then activated by host cell enzymes to form a multimeric complex on the host cell surface
- LF or EF bind this complex & are internalized by the cell
What is Anthrax a primary disease of?
Herbivores: Cattle, sheep, goats, and horses
*This can be cultured on almost any farm; animals and soil are the principal reservoirs but there are only 1-2 cases anually
How is Anthrax prevented?
Vaccine in both animals and humans
What are the three types of Anthrax disease?
1) Inoculation
2) Inhalation
3) Ingestion
What is inoculation anthrax?
Direct inoculation of spores into open cuts or wounds
- Spores from soil, animal fur, hides, wool, or skin
What is inhalation anthrax?
Inhalation of spores
- Bioterrorism
- Previously called “wool-sorters disease”
What is ingestion anthrax?
Ingestion of spores
Describe the progression of Cutaneous anthrax.
1) Small red papule
2) Vesicle
3) Necrotic ulcer (eschar) is formed
*Described as painless & 5-20% are fatal without treatment
Describe the presentation of inhalation anthrax.
1) Initially presents as non-productive cough, dyspnea, myalgia, fatigue, and fever
2) Progresses to fever, drenching sweats, & severe dyspnea/cyanosis
3) By 3rd day, death in 100% without treatment
*Note that there is a long incubation period; pneumonia is rare; meningeal symptoms are in half of the cases
Describe the presentation of gastrointestinal anthrax.
1) Upper GI involvement includes oro-pharyngeal ulcerations with cervical lymphadenopathy & fever
2) Intestinal involvement includes abdominal pain, nasuea, fever, hematemesis, & hematochezia
*Note that the fatality rate with this disease is ~100%
How is gastrointestinal anthrax acquired?
Ingesting contaminated meat (likely with black eschar)
How is anthrax diagnosed?
- Clinical signs
- History
- Microscopy
- Culture
*Must inform lab that anthrax is suspected & handled under certain containment conditions
How is cutaneous (non-bioterrorism) anthrax treated?
Amoxacillin
How is inhalation, gastroinestinal, or bioterrorism anthrax treated?
- Doxycycline or Ciprofloaxcin with 2x additional antibiotics
What is is causative organism of Brucellosis?
Brucella
List the characteristics of Brucella.
- Gram negative coccobacilli
- Intracellular pathogen
*Requires specialized media for culture
How is Brucella transmitted?
Aerosol or ingestion of
- Contaminated food
- Direct contact with infected animal
Describe the presentation of Brucellosis.
- Acute undulating fever with joint pain, headache, & drenching sweat
- This daily undulating fever is pathognomonic for Brucella/ Brucellosis
*Fever starts in the evening and is normally done by the morning
What does Brucella infection cause during pregnancy?
Spontaneous abortion
Premature delivery
Miscarriage
*Because of this, lab must be notified if this is what you suspect the patient may have
How is Brucellosis diagnosed?
- Patient history
- Lab MUST be notified
- Blood culture
- Serology
- PCR
What is the treatment for Brucellosis?
6+ week course of Tetracycline (doxycycline) & rifampin