Primate Medicine Flashcards
Two agents that cause tuberculosis
M. tuberculosis
M. bovis
Tuberculosis-transmission
aerosol
Tuberculosis-testing
problems; especially in orangutans
Clinical signs-tuberculosis
mild to severe; initially respiratory
Polio-transmission
Fecal-oral with environmental contamination
Prevention-tuberculosis
personnel management
Prevention-polio
human vaccination
hygiene
ape vaccination
management (?)
Polio symptoms
none to paralysis
Measles-transmission
aerosol
Measles-symptoms
none to skin lesions to resp.
Measles - prevention
personnel management, ape vaccination
Resp. myxovirus-causes
Influenza
Parainfluenza
Resp. syncytial virus
Resp. myxovirus - transmission
aerosolization of secretions
Resp. myxovirus clinical signs
generalized signs or mild to severe resp. disease w/ 20 bacterial infections
Bacterial enterocolitis-causes
- shigella
- salmonella
- campylobacter
Bacterial enterocolitis - transmission
fecal-oral & environmental contamination
Bacterial enterocolitis signs
none, dysentery; systemic signs, including meningitis
Prevention-bacterial enterocolitis
Personnel management, hygiene
Three “scary” zooanthroponoses
- Herpes Simian B Virus
- Ebola Virus
- Marburg Virus
Pathogenesis of herpes B virus in natural host
similar to herpes simplex-humans
Herpes B Virus in humans
severe neurologic impairment; severe brain damage or death unless treatment initiated after exposure
When was last identified case of Herpes B virus? Last fatality?
2008
last fatality in 1997-researcher splashed in eye with urine of infected ape
Drug that may prevent progression of Herpes B in humans?
acyclovir
Cause of ebola hemorrhagic fever
RNA virus in family Filoviridae
When was ebola first recognized?
1976
How to maximize prognosis for ebola
- early detection
- manage electrolyte & fluid balance
- maintain oxygen status and blood pressure
- treat concomitant infections
Ebola-transmission
via mucous membranes, breaks in skin, or parenteral
- infected body fluids, secretions
- person-person
- fomites
Five major zoonotic concerns
- Tuberculosis
- Polio
- Measles
- Resp. Myxoviruses
- Bacterial enterocolitis
Ebola-cell types infected? migrates to where in body?
Infects monocytes, macrophages, dendritic cells, endothelial cells, fibroblasts, hepatocytes, adrenal cortical cells, epithelial cells
Migrates to regional lymph nodes, liver, spleen and adrenal glands
Why are hemorrhagic symptoms seen with ebola?
- coagulopathies related to hepatocellular necrosis
- impairment of clotting and vascular leakage due to release of cytokines
Why is hypotension seen with ebola?
adrenocortical necrosis
When is onset of fever and symptoms in patients with ebola?
abrupt onset 8-12 days after exposure
Ebola can be mistake for what other diseases due to initial non-specific symptoms
- malaria
- typhoid fever
- meningococemia
- pneumonia & other bacterial infections
“later onset” symptoms of ebola (about 5 days after initial nonspecific symptoms)
- severe watery diarrhea
- nausea
- vomiting
- abdominal pain
- chest pain
- shortness of breath
- headache
- confusion
- conjunctival injection
- seizures, cerebral edema reported
- hiccups reported
- bleeding (variety of manifestations)
- possibly diffuse erythematous maculopapular rash
- pregnant women-spontaneous miscarriages
Usual cause of death seen with ebola; timeframe for death?
multiorgan failure, septic shock within 6-16 days
Cause-Marburg virus
RNA virus of filovirus family
Marburg virus is associated with what non-human primates?
African green monkeys
Reservoir host-Marburg virus
African Fruit Bat
does not affect them
Suspected transmission of Marburg virus to humans
exposure to bat feces/aerosols; person to person transmission as well
Characteristic signs of Marburg virus
sudden onset headache, myalgia, macropapular rash prominent on trunk
Ddx for primate patient with diarrhea
Salmonella
Shigella
Campylobacter
Ddx for primate patient with bloody diaper
Diaper rash UTI Uterine Diseases -endometritis -uterine cancer -endometriosis
Causes of bacterial pneumonia in primates
Streptococcus Klebsiella Staphylococcus Haemophilus Bordetella
Ddx for primate patient with neurologic signs
Trauma
Rabies
Viral encephalitis
New world monkey characteristics
- primarily tree dwellers
- no marked sexual dimorphism
- no cheek pouches
- prehensile tails
New world monkeys seen as pets
- Marmosets
- Owl monkeys
- Capuchin
- Spider monkey
Old world monkey characteristics
- various habitat; rainforest-desert
- marked sexual dimorphism
- ischeal callosities
- some have cheek pouches
- tails not prehensile, if they have them
Vaccinations for primates
MMR
Tetanus
Rabies
MMR vaccination plans?
at 6-18 months and 10 years
or
after 15 months and 10 years
Tetanus vaccination plans?
2, 4, 5, and 18 months, 5 years, every 10 years
or
annually for 3 years, then every 3 years
or
annually for three years, then every 10 years
Rabies vaccination plans?
6 months then annually or vaccinate once then every 1-3 years or annually and repeat based on titers
TB testing
commonly at 18 months then annually
Organisms tested for with fecal culture?
Shigella
Salmonella
Campylobacter
Fecal culture frequency?
annually
Basic principles of a primate visit
- owner should bring monkey in cage/carrier
- move owner and monkey into exam room ASAP
- avoid unnecessary eye contact
- control situation
- chemical restraint unless infant, young, or moribund patient and nonpainful procedure
- be organized to take advantage of immobilization
