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Microbiology SPP > Filariases > Flashcards

Filariases Flashcards

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Biology 101 flashcards
1
Q

Common name for a group of diseases caused by ————-

A

filarial worms

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2
Q

Pathogenic spp include:

Non-pathogenic spp include:

A

Pathogenic spp.:
✓ Wuchereria bancrofti; W. bancrofti var. pacifica
✓ Brugia malayi; B. timori
✓ Loa loa
✓ Onchocerca volvulus
Non-pathogenic spp:
✓ Mansonella perstans
✓ Mansonella streptocerca
✓ Mansonella ozzardi

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3
Q

Widely distributed in trop./subtrop such as:

A

Widely distributed in trop./subtrop. Africa, America, Asia

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4
Q

Transmitted by ——— vectors: non-pathogenic sp. mainly by ——— sp.

A

Transmitted by dipteran vectors: non-pathogenic sp. mainly by Culicoides sp.

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5
Q

Loa loa transmitted by

A

Deer fly-chrysops

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6
Q

Onchocerca volvulus is transmitted by

A

Black fly

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7
Q

Periodicity is seen only in?

A

Microfilariae

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8
Q

Periodicity
▪ nocturnal include
▪ diurnal include

A

:
▪ nocturnal: W. bancrofti (save sub-periodic W. bancrofti var. pacifica)
• B. malayi (save sub-periodic strains); B. timori
▪ diurnal: L. loa

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9
Q

▪ nocturnal: W. bancrofti (except ———- W. bancrofti var. ——-)
• B. malayi (save ——-strains); B. timori
▪ diurnal: L. loa

A

:
▪ nocturnal: W. bancrofti (save sub-periodic W. bancrofti var. pacifica) • B. malayi (save sub-periodic strains); B. timori
▪ diurnal: L. loa

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10
Q

———- can also be found outside the time period

A

Sub periodic

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11
Q

Microfilariae of pathogenic group are sheathed. T or F

A

T

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12
Q

Microfilariae of pathogenic group are sheathed; except

A

Onchocerca volvulus

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13
Q

microfilariae of ———- are not sheathed & do not exhibit periodicity

A

microfilariae of Onchocerca

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14
Q

Microfilariae (mf) of pathogenic spp have nuclear arrangement at ——— & ——— ends taxonomic; helps you tell the ——— of microfilariae

A

Microfilariae (mf) of pathogenic spp have nuclear arrangement at cephalic & caudal ends taxonomic; helps you tell the specie of microfilariae

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15
Q

Distinguishing features of microfilariae (mf) based on no. & position of ——— in cephalic & caudal end

A

nuclei

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16
Q

LYMPHATIC FILARIASIS
Aetiologic agents:
➢ it is one of the 21 ———
➢ Global estimates:
✓ ———- at risk in — countries (≈ —% live in ———-, Cameroon, Côte d’Ivoire, DR Congo, India, ———, Mozambique, ———, Nigeria [> —- million], Tanzania)
✓ > ——— infected (——— LF-related morbidity)
✓ elimination (which countries )

A

LYMPHATIC FILARIASIS
Aetiologic agents: W. bancrofti; B. malayi; B. timori
➢ it is one of the 21 Neglected Tropical Diseases
➢ Global estimates:
✓ 856 million @ risk in 52 countries (≈ 80% live in Angola, Cameroon, Côte d’Ivoire, DR Congo, India, Indonesia, Mozambique, Myanmar, Nigeria [> 100 million], Tanzania)
✓ > 120 million infected (40 million LF-related morbidity)
✓ elimination (China; Korea; Maldives; Sri Lanka; Cambodia; Cook Islands; Niue, Vanuatu; Togo; Egypt)

17
Q

LYMPHATIC FILARIASIS
➢ Transmission ensured by ———
➢ Residents of ——— areas @ greatest risk
➢ Causes ———-; leading cause of permanent disability

A

➢ Transmission ensured by mf periodicity
➢ Residents of endemic areas @ greatest risk
➢ Causes disfiguration; leading cause of permanent disability

18
Q

microfilarial periodicity = ——— time

A

vector feeding time

19
Q

Morphology & Development
➢ the microfilariae is ——- & ———
➢ male and female inhabit ——,——— (≈ — to —yr)
➢ female shed mf ———- which finds its way to the ——-
➢——- ingest mf; → then through the ——- → to the ——— muscles ( L3 develops — to —days after infection .) haemocoel → proboscis
➢Human infection: mf →goes through ———

A

Morphology & Development
➢ the microfilariae is whitish& filamentous
➢ male and female inhabit lymphatic vessels, l/nodes (≈ 5 to 7yr)
➢ female shed mf nocturnally which finds its way to the blood
➢mosquitoes ingest mf; → then through the gut wall → to the thoracic muscles ( L3 develops 9-13 days after infection .) haemocoel → proboscis
➢Human infection: mf →goes through skin

20
Q

Pathology/Clinical Features
➢ Most, asymptomatic; subclinical lymphatic dilatation & dysfunction
➢ Pathogenicity: ——filariae> ——filariae
➢ Incubation period usually ≤ — - — months
➢ Onset of symptoms: y/adults → l/nodes: symptoms begin when ——- get to lymph nodes
✓————-
✓ acute attack; — - — days (——spp)
▪ can recur severally in the course of a year T or F
▪ induration around ———»» whole limb

A

Pathology/Clinical Features
➢ Most, asymptomatic; subclinical lymphatic dilatation & dysfunction
➢ Pathogenicity: macrofilariae>microfilariae
➢ Incubation period usually ≤ 8 - 16 months
➢ Broad range of symptoms vary considerably regionally
➢ Onset of symptoms: y/adults → l/nodes: symptoms begin when adults get to lymph nodes
✓ lymphadenitis (inguinal &/or axillary »» deep abdominal): mild headache, fever & malaise
✓ acute attack; — - — days (——spp)
▪ can recur severally in the course of a year T
▪ induration around l/nodes »» whole limb

21
Q

➢ Death of adult worms:(death will lead to ——-)
Death of worm causes:
✓ ————
✓————
✓————

A

➢ Death of adult worms:
✓ lymphadenitis & lymphangitis
✓ funiculitis/epididymitis/orchitis (W. bancrofti): 25 million ♂ suffer genital dis. globally
funiculitis = inflammation of spermatic cord
✓ lymphadenitis @ intervals (B. malayi): shivers, fever, other general symptoms

22
Q

funiculitis/epididymitis/orchitis (——spo): — million male suffer genital dis. globally
funiculitis = inflammation of ———
✓ lymphadenitis @ intervals (———spp): presents with:

A

✓ funiculitis/epididymitis/orchitis (W. bancrofti): 25 million ♂ suffer genital dis. globally
funiculitis = inflammation of spermatic cord
✓ lymphadenitis @ intervals (B. malayi): shivers, fever, other general symptoms

23
Q

➢ Chronicity (— to —15 yr):
✓———-

hydrocele is a fluid-filled sac around a ——-

chyluria = lymphatic fluid leaks into the ——- & turns the urine ——- colour

✓ lymphedema (> — million) leads to ——- (≈ —%); microhaematuria & proteinuria
➢ TPES may occur:

TPES occurs more in ——— sp in Asia than ———

✓ diffuse lung infiltrations
✓ ↑ ——— + ↑ levels of —— &antifilarial——(hence can be diagnosed ———-)
✓ no peripheral ———(they are in the ———)
✓ symptoms include:

A

➢ Chronicity (10 - 15 yr):
✓ hydrocele & chyluria (W. bancrofti)

hydrocele is a fluid-filled sac around a testicle

chyluria = lymphatic fluid leaks into the kidneys & turns the urine milky white

✓ lymphedema (> 15 million) »» elephantiasis (≈ 30%); microhaematuria & proteinuria
➢ TPES may occur:

TOESoccurs more in brugia sp in Asia than wuchereria

✓ diffuse lung infiltrations
✓ ↑ eosinophilia + ↑ levels of IgE & antifilarial Abs(hence can be diagnosed serologically)
✓ no peripheral microfilaraemia(they are in the lungs)
✓ cough, fever, dyspnoea & wheezing (can be worse at night )

24
Q

➢Brugia filariasis:
✓ typified by lower leg & lower arm ——
✓chronic cases: frequent ——-
—% of elephantiasis patients amicrofilaraemic in the Pacific & Indonesia

A

➢Brugia filariasis:
✓ typified by lower leg & lower arm elephantiasis
✓chronic cases: frequent amicrofilaraemia (40% of elephantiasis patients amicrofilaraemic in the Pacific & Indonesia)

25
Q

Diagnosis
> Microscopy (for mf):
- fresh —— samples
-———– or haematoxylin-eosin stained (thick/thin?)smears
—Provocation test:
used to diagnose infections in areas where microfilariae exhibit ———-
periodicity
- oral — mg —- leads to increased microfilaraemia (30 - 60 min)
-& severe ——— rxn in areas with mixed filariasis
life threatening reaction that occurs within — days of treatment of microfilariasis
> QBC technique
- also called————— technique; examine ———after ————

A

Diagnosis
> Microscopy (for mf):
- fresh blood samples
-Giemsa- or haematoxylin-eosin stained thick smears
—Provocation test:
used to diagnose infections in areas where microfilariae exhibit nocturnal
periodicity
- oral 100 mg DEC »» ^ microfilaraemia (30 - 60 min)
-& severe Mazzotti rxn in areas with mixed filariasis
life threatening reaction that occurs within 7 days of treatment of microfilariasis
> QBC technique
- Quantitative buffy coat technique; examine buffy coat after centrifugation

26
Q

Diagnosis
Biopsy of palpable ———-;you see the adults (L—)
• Membrane/Nucleopore filtration (pore size, — um)
microfilariae are >—um in size
- Serological:
Point of Care - Rapid Diagnostic tests
POC-RDTs (bancroftian filariasis)examples:
-
•
- increased levels of antifilarial ———, ———, ———, ———,

-Ultrasonography
- Lab tests generally -ve in patients with ————

A

Diagnosis
Biopsy of palpable I/nodes;you see the adults (L5)
• Membrane/Nucleopore filtration (pore size, 3 um)
microfilariae are >3um in size
- Serological:
Point of Care - Rapid Diagnostic tests
POC-RDTs (bancroftian filariasis)examples:
-BinaxNOW® Filariasis(detecting antigens)
•Filariasis Test Strip (FTS)
- increased levels of antifilarial IgG4: CFT, IHAT, IIFT, ELISA
(complement fixation test, indirect hemagluttinin test, indirect immunofluorescent test, ELISA respectively)
-Ultrasonography
- Lab tests generally -ve in patients with lymphedema

27
Q

Treatment &/or Management;include
.
.
.
.

A

Treatment &/or Management
➢ **DEC: 6 mg/kg (/d x 7 - 12 d) or (/wk x 6 wk)
> Ivermectin or DEC + Albendazole
> Doxycycline (200 mg/d × 6 wk)
• Hydrocelectomy surgery

28
Q

Treatment &/or Management
> *** DEC: —mg/kg (/d x 7 - 12 d) or (/wk × 6 wk); micro and macrofilaricidal.T or F
> Ivermectin or DEC + Albendazole
——— preferred to ——- due to its toxicity
> Doxycycline (——mg/d × 6 wk) kills ——-
• Hydrocelectomy surgery to remove ——-

A

Treatment &/or Management
> *** DEC: 6 mg/kg (/d x 7 - 12 d) or (/wk × 6 wk); micro- and macrofilaricidal
> Ivermectin or DEC + Albendazole
ivermectin preferred to DEC due to is toxicity
> Doxycycline (200 mg/d × 6 wk) kills Wolbachia
• Hydrocelectomy surgery to remove hydrocele

29
Q

Prevention & Control
• PC: MDA; (Preventive chemotherapy: Mass Drug Administration)
I/annual ————- (400 mg) +:
rx of onchocerca is ————
. Ivermectin (— mg/kg) in areas co-endemic for ———
DEC (6 mg/kg) +/- Ivermectin (200 g/kg) in some areas (no ———)
2/annual —— mg albendazole in areas co-endemic for ———
Treatment for loa is ——- & ———

• Vector control:
- ————-
- ————-

bio-control: biological larvicides include

A

Prevention & Control
• PC: MDA; (Preventive chemotherapy: Mass Drug Administration)
I/annual albendazole (400 mg) +:
rx of onchocerca is IVERMECTIN
. Ivermectin (200 mg/kg) in areas co-endemic for oncho
DEC (6 mg/kg) +/- Ivermectin (200 g/kg) in some areas (no oncho)
2/annual 400 mg albendazole in areas co-endemic for loiasis
Tx for loa is DEC & ALBENDAZOLE
• Vector control:
V eliminate breeding sites
V insecticiding +/or larviciding
bio-control: Bacillus thuringiensis var. israelensis (Bti); B. sphaericus
biological larvicides

30
Q

-

— “Integrated approach: annual MDA (decreases ————; decreases ———) +
——- control = Basis of global campaign for elimination
• Elimination: —— (2020)

A

• Avoid vector bites:
- repellents (DEET) DIETHYLTOLUAMIDE
- mechanical prev. measures

— “Integrated approach: annual MDA (decreases microfilaraemia; decreases transmission) +
vector control = Basis of global campaign for elimination
• Elimination: Togo (2020)

Microbiology SPP (2 decks)

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