MI: Zoonoses Flashcards

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1
Q

Define zoonoses

A

Diseases that is transmitted from animals to humans

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2
Q

List some examples of new emerging infectious diseases that are zoonoses.

A
  • Viral haemorrhagic fever
  • Respiratory diseases (MERS)
  • Novel influenza virus (pH1N1)
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3
Q

List three ways in which zoonoses are transmitted.

A
  • Everyday contact with animals (scratches and bites)
  • By-products (faeces/urine) leading to contaminated soil
  • Foodstuffs (undercooked meats, milk)
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4
Q

List examples of:

  1. Farm/Wild Animals
  2. Companian Animals
A

Farm/Wild Animals
* Cattle
* Poultry
* Goats
* Pigs

Companion Animals
* Cats and dogs
* Reptiles and amphibians
* Fish

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5
Q

Give examples of zoonoses in the UK that are transmitted by:

  1. Farm/wild animals
  2. Companion animals
A

Farm/wild animals:

  • Campylobacter
  • Salmonella

Companion animals:

  • Toxoplasmosis
  • Bartonella
  • Ringworm
  • Psittacosis
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6
Q

Give examples of zoonoses in tropical countries that are transmitted by:

  1. Farm/wild animals
  2. Companion animals
A

Farm/wild animals:

  • Brucella
  • Coxiella
  • Rabies
  • VHF

Companion animals:

  • Rabies
  • Tick-borne diseases
  • Spirilum minus
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7
Q

For Campylobacter, describe the following:

  • Reservoir
  • Transmission
  • Clinical presentation
  • Investigations
  • Management
A
  • Reservoir = poultry, cattle
  • Transmission = contaminated food
  • Clinical presentation = bloating, diarrhoea, cramps
  • Investigations = stool culture
  • Management = supportive
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8
Q

For Salmonella, describe the following:

  • Reservoir
  • Transmission
  • Clinical presentation
  • Investigations
  • Management
A
  • Reservoir = poultry, reptiles/amphibians
  • Transmission = contaminated food, poor hygiene
  • Clinical presentation = diarrhoea, vomiting, fever, no flatus
  • Investigations = stool culture
  • Management = supportive, ceftriaxone
    or azithromycin
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9
Q

For Bartonella henselae (cat scratch disease) describe the following:

  • Reservoir
  • Transmission
  • Clinical presentation
  • Investigations
  • Management
A
  • Reservoir = kittens > cats
  • Transmission = scratches, bites, licking open wounds, fleas
  • Clinical presentation = macule at site of innoculation - becomes pustular, regional tender lymphadenopathy, systemic symptoms
  • Investigations = serology
  • Management = erythromycin, doxycyline
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10
Q

What can happen when Bartonella infects someone who is immunocompromised?

A

Bacilliary angiomatosis

  • Causes multiple skin papules
  • Multi-organ and vasculature involvement
  • Leads to bursting of blood vessels in various organs and tissues
  • Can be FATAL
  • Diagnosed with histology and serology
  • Treated with erythromycin, doxycyline PLUS rifampicin
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11
Q

For Toxoplasmosis, describe the following:

  • Reservoir
  • Transmission
  • Clinical presentation
  • Investigations
  • Management
A
  • Reservoir
    • Cats
    • Sheep
  • Transmission
    • Infected meat
    • Faecal contamination
  • Clinical presentation (largely asymptomatic in immunocompetent)
    • Mononucleosis type symptoms: sore throat, fever, lymphadenopathy
    • Pregnancy: stillbirth or neonates with progressive visual, hearing, motor and cognitive issues
    • Encephalitis and chorioretinitis in immunocompromised
  • Investigations
    • Serology
  • Management
    • Pyrimethamine + sulfadiazine (first line)
    • Spriamycin
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12
Q

For Brucellosis, describe the following:

  • Reservoir
  • Transmission
  • Clinical presentation
  • Investigations
  • Management
A
  • Reservoir
    • Cattle
    • Goats
  • Transmission
    • Unpasteurised milk
    • Undercooked meat
    • Aerosolisation/inhalation
  • Clinical presentation
    • Undulant fever - wave like (and rest of FLAWS)
    • Back pain (osteomyelitis)
    • Orchitis
    • Focal abscess (psoas or liver) and endocarditis
  • Investigations
    • Blood/pus culture
    • Serology : anti-O-polysaccharide antibody
    • NOTE: the lab should be warned that you are sending suspected Brucella
  • Management
    • Doxycycline + streptomycin/ rifampicin
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13
Q

Which organism causes Q fever?

A

Coxiella burnetii

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14
Q

For Coxiella burnetii, describe the following:

  • Reservoir
  • Transmission
  • Clinical presentation
  • Investigations
  • Management
A

Reservoir:

  • Goats
  • Sheep
  • Cattle

Transmission:

  • Aerosolisation/inhalation of infected animal secretions, waste, milk
  • Unpasteurised milk

Clinical presentation:

  • Fever
  • Flu-like illness
  • Pneumonia (atypical)
  • Hepatitis
  • Endocarditis
  • Focal abscess (paravertebral, discitis)

Investigations

  • Serology

Management

  • Doxycycline
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15
Q

Common anecdote for Coxiella

A

Common in farms: farmers reusing hay which smells so they open the barn doors - allows aerosolisaiton of the bacteria and spreading to others

Multi-lobar pneumonia

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16
Q

Which infectious agent causes Rabies?

A

Lyssa virus

17
Q

For rabies, describe the following:

  • Reservoir
  • Transmission
  • Clinical presentation
  • Investigations
  • Management
A

Reservoir:

  • Dogs
  • Cats
  • Bats

Transmission:

  • Bites
  • Scratches

Clinical presentation:

  • Seizures
  • Excessive salivation
  • Hydrophobia
  • Agitation
  • Confusion
  • Fever
  • Headache
    NOTE: 100% mortality once symptomatic

Investigations:

  • Serology for IgM,
  • Negri bodies (pathognomonic)
  • Brain biopsy
  • Saliva PCR

Management:

  • Immunoglobulin
  • Vaccine (can be given post-exposure)
18
Q

Which two infectious agents can cause rat bite fever?

A
  • Streptobacillus moniliformis
  • Spirilum minus
19
Q

For rat bite fever, describe the following:

  • Reservoir
  • Transmission
  • Clinical presentation
  • Investigations
  • Management
A

Reservoir:

  • Rats

Transmission:

  • Bites
  • Contact with infected urine/ droppings

Clinical presentation:

  • Fevers
  • Polyarthralgia
  • Maculopapular progressing to purpuric rash
  • Can progress to endocarditis

Investigations:

  • Joint fluid MC&S
  • Blood culture

Management:

  • Penicillins
20
Q

When do humans most frequently come into contact with rat bite fever

A

Contaminated freshwater - e.g. swimming in contaminated river

21
Q

For Hantavirus pulmonary syndrome, describe the following:

  • Reservoir
  • Transmission
  • Clinical presentation
  • Investigations
  • Management
A

Examples: Sin Nombre virus, Black canal virus, Bayou virus

Reservoir:

  • Mice and rats

Transmission:

  • Contact with infected urine/ droppings
  • Aerosolisation

Clinical presentation:

  • Fever
  • Flu-like illness
  • Myalgia
  • Respiratory failure (USA)
  • Bleeding
  • Renal failure (SE asia)

Investigations:

  • Serology
  • PCR

Management:

  • Supportive
22
Q

Which viruses cause viral haemorrhagic fever?

A
  • Ebola
  • Marburg
  • Lassa
  • Crimean-Congo haemorrhagic fever
23
Q

For viral haemorrhagic fever, describe the following:

  • Reservoir
  • Transmission
  • Clinical presentation
  • Investigations
  • Management
A

Reservoir:

  • Ebola - bats?
  • Marburg - bats?
  • Lassa - rats
  • Congo-Crimean haemorrhagic fever - ticks

Transmission:

  • Contacts with infected fluids

Clinical presentation:

  • Fever
  • Myalgia
  • Flu-like illness
  • BLEEDING

Investigations:

  • Serology
  • PCR

Management:

  • Supportive
24
Q

What investigations would you conduct in patients with suspected zoonoses?

A
  • Culture - blood, pus, CSF, stool
  • Serology
  • PCR
25
Q

How would you manage patients with zoonoses?

A
  • Isolate patient
  • Phone infectious diseases
  • Notify PHE