Q-Fever Flashcards
- What are the other names that Q-fever goes by?
a. • Query Fever
b. • Coxiellosis
- What is the causative agent of Q-fever?
a. . Coxiella burnetti
- Is Coxiella burnetti gram positive eor gram negative?
a. Graham neg
- Is Coxiella burnetti a spore former?
a. Yes
- Can pasteurisation kill Coxiella burnetti?
a. Yes
- Coxiella burnetti exists in ______ antigenic phase
a. Two
- What are the two antigenic phases that Coxiella burnetti exists in?
a. •Phase 1: virulent
b. •Phase 2: less pathogenic
- What is the phase 1 of Coxiella burnetti?
a. Virulent
- What is phase 2 of Coxiella burnetti?
a. Less pathogenic
- Where does Coxiella burnetti replicate?
a. Monocytes or macrophages
- What was Coxiella burnetti thought to be originally and why?
a. Rickettsial agen
b. Transmitted by tick
- What phylum does Coxiella burnetti belong?
a. Proteobacteria.
- What other bacteria are part of the proteobacteria?
a. Legionella and salmonella
- What percentage of bacteria are proteobacteria?
a. 32%
- All proteobacteria are Gram Positive (t/F)
a. False
- Is Coxiella burnetti an environmentally stable organism?
a. Yes
- Why is Coxiella burnetti able to be so resistant to deissinfection agents that normally kill bacteria?
a. Its spore structures
- How long can Coxiella burnetti spore survive in room temperature outside of a host?
a. 7-10 days
- How long can Coxiella burnetti spores survive in a fresh meat stored at 4C?
a. A month
- How many day s can Coxiella burnetti spores survive in dust?
a. 120days
- How long can Coxiella burnetti spores survive in skim milk?
a. 40 months
- How can Coxiella burnetti spores be killed?
a. pasteurisation
- What is the phase that Coxiella burnetti is most commonly found?
a. Phase 1
- When is phase 2 of Coxiella burnetti typically discovered?
a. Through multiple passes of cell culture in the lab.
- Phase one is a _________ infection whereas phase two is a ________ infection.
a. Chronic
b. Acute
- How does Coxiella burnetti infect macrophages?
a. Binds to an αvβ3 integrin: Triggering phagocytosis
i. This is an actin dependent mechanism
b. Nascent (beginning once inside the cell) Coxiella-containing vacuole (CCV) acquires early endosome markers
i. RAB5 , EEA1 and microtubule-associated protein light-chain 3 (LC3 - autophagosome marker)
ii. This can take place within 5 minutes of the bacterium being internalised
c. Autophagosome binds to the nacent CCV
i. Lowers the pH to ~5.4
d. Maturing CCV acquires RAB7 and lysosome-associated membrane glycoprotein 1 (LAMP1)
i. The pH then decreases even further ~5 pH
e. Lysosomal enzymes – eg cathepsin D (CTSD) start to accumulate
i. pH drops again to ~4.5
ii. This happens within 2 hours of internalisation
f. Conversion of bacteria from small cell variants (SCVs) to metabolically active large cell variants (LCVs) - involves the recruitment of both RHO GTPase and RAB1B
i. RAB1 is recruited from the endoplasmic reticulum thought to acquisition of additional membranes to create a large vacuole
- What is the estimated life cycle from invasion of macrophages to production of large replication vacuoles?
a. 20 hours
- _________ – Febrile disease -Abattoir workers, Brisbane: What was the desease called at this stage and why?
a. 1935
b. Query fever
c. As the cause fo the disease was unknown
- The disease is named after a scientist called _____?
a. Burnet
- _________ Montana, USA – pathogen isolated from ticks in the nine mile.
a. 1938
- ________ the bacterium got the name coxella burnetti because of the two scientists
a. 1938
- ______ a lot of cases being reported amongst military personal, both USA and British, in Mediterranean particularly Italy
a. 1940
- In the 1940s those in cities became ill form Coxiella burnetti, these cities where down wind of infected farmsm, which led to what discovery
a. The disease is Airborne
- Ho can Coxiella burnetti be transmitted?
a. Aerosol
b. Direct contact
c. Fomites
d. Ingestion
e. Ticks: Arthropods
- What is the most common animal to spread Coxiella burnetti to humans and through what transmission route?
a. Cows, sheeps, and goats
b. Aerosols
- How can aerolisation of Coxiella burnetti happen?
a. Parturient fluids
i. • 109 bacteria released per/gram /placenta
b. – Urine, faeces, milk
c. Blood from meat plants
- What is a parturient fluid?
a. Birthing fluids
b. NASSSY
- What fomites can be an issue?
a. Can survive on clothes for 7-10 hours
b. Can survive on animal bedding and other items
- How is Coxiella burnetti typically consumed?
a. Unpasteurised milk
b. Infected meats
c. Placenta when eaten by animal, including pets
- What kind of infection is it when an arthropod passes the Coxiella burnetti down to the offspring?
a. Transovarial infection
- What is a transtatial infection?
a. Passed between life cycle stages
- ~What arthropods can spread Coxiella burnetti?
a. Flies
b. Lice
c. Beetle
d. Ticks
e. Coachroaches
f. Mites
- How long can infection persist in an artropd?
a. Up to nine months
- How is person-Person transmitted?
a. Congenital
b. – Blood transfusions
c. – Bone marrow transplants
d. – Intradermal inoculation
e. – Possible sexual Transmission
- Is person to person common?
a. NOPE
- Where is Coxiella burnetti found?
a. Globally apart from new Zealand
- What reseviours are there of Coxiella burnetti?
a. Domestic farm Animals: Sheep, cattle, goats, dogs, cats
b. Birds
c. Repltiles
d. Wildlife
e. Ticks
- What are the three main reseviours of the Coxiella burnetti?
a. Sheep, goats, and ticks
- Nova scotia have other reservoirs which are?
a. Wild life: snow shoes hares, whitel tailed deer, and moose
- In Americas what is another reseviour of Coxiella burnetti?
a. Black bears
- In what direction is it thought that the spill over goes between domestic and wild animals?
a. Spill over from farm the wild bois
- What are the high risk occupations?
a. Agricultural workers
b. –Livestock producers
c. –Veterinarians & nursing staff
d. –Meat processors/abattoir
e. workers
f. –Laboratory workers
g. –Wildlife workers
- What is the prevalence in UK… of that population of infected how many are farmers 15%, an what is the explanation for the rest of the infected?
a. UK 5% population seropositive
b. 15% farmers
c. Unknown
- ____-______ sporadic cases/year reported of Coxiella burnetti infection each year, but this is thought to be grossly underestimated as ________% of cases are asymptomatic.
a. 50-100
b. 60%
- Is infection with Coxiella burnetti in children uncommon…..
a. Yes it is
- There was an outbreak in _____, with 95 cases thought to be caused by airborne transmission, from ________ who gave birth in the straw in the walls.
a. 2002
b. mice
- Outbreak in ________ with 30 people infected, living down wind from a farm
a. 2007
- Outbreak, in a farm dance from contaminated from ___________ from birthing sheep
a. Haybales
- Q. Fever in N, Ireland Peakined in _______ with 35 people being infected but has continued to decrease with an average of 1-2 cases per year
a. 2000
- _______ to _______ was the greatest outbreak of Coxiella burnetti, in Netherlands because of ________ farms, with 4,000 cases and there were __________ animals euthanized.
a. 2007 -2010
b. Dairy goat
c. 50,000 euthanized, all with twin pregnancy
- In the 2007-2010 Netherlands outbreak what were the most common patients to become infected with Coxiella burnetti?
a. Male
b. Smokers
c. 40-60years of age
- The most common (______%) clinical presentation of Coxiella burnetti in the 2007-2010 outbreak was _________
a. 62%
b. Pneumonia
- What was the percentage of people working in an agricultural position or the meat processing industry in the 2007-2010 Netherlands outbreak?
a. 2%
b. 0.5%
- The outbreaks of the 2007-2010 Netherlands outbreaks of Coxiella burnetti coensided with what phenomenon?
a. Coxiella burnetti induced abortions in the dairy goats
- In Denmark __________ 18 million mink culled when worker introduced covid-19.
a. 2022
- Disease manifestation in humans: a. incubation period b. mean incubation rate c. % asymptomatic. D. how longs acute infection. E. how lond is the chronic infection
a. 2-40 days
b. 20 days
c. 50-60% asymptomatic
d. Acute: 6month
e. Chronic: 6+ months
- In regards tp humans we are a ___________ host.
a. Dead end host
b. Bad at passing the disease on
- How does acute Coxiella burnetti infection manifest? What is the percentage of deaths?
a. Flu-like, self limiting
b. Atypical pneumonia (30 to 50%)
c. Hepatitis
d. Skin rash (10%): Exanthema
e. Other signs (< 1%)
i. –Myocarditis (heart inflammation) meningoencephalitis (behavioural problems), pericarditis (pericardium inflammation)
f. Death: 1 to 2%
- Those with acute acute Coxiella burnetti infection that develop atypical pneumonia what can this develop into? And what does it appear as in an xray? What else develops?
a. Pneumonitis
b. Viral pneumonia
c. Pleural infusion: liquid build up
- How does the chronic disease manifest? A. How long does it last. B.What percentage of people infected with Coxiella burnetti get this form? C. Who is at higher risk of this form? D. What is the most common manifestation e. Where can granulomas develop and what issues does this lead to? F. Where is can be infected? G. What is the relapse rate after antibiotic treatment?
a. 6+ months
b. 1-5%
c. Heart problems, pregnant women, immunocompromised, organ transplant and cancer
d. Endomyocardial disease
e. Liver: cirrhosis and Granulomatous hepatitis
f. Bone: osteoperosis
g. 50% relapse
- Where do scientist believe are the target cells for Coxiella burnetti?
a. Kupffer
- How long can someone with the acute form of Coxiella burnetti infection develop the chronic form?
a. Up to 20 years after
- The majority of women who are pregnant are manifest the disease Coxiella burnetti how?
a. Asymptomatically
b. Premmie birth
c. Placentitis
- Coxiella burnetti is usually ________ resolving in _____ days to ______ weeks
a. Self limiting
b. 2days to 2 weeks
- Only ________ develop severe disease of Coxiella burnetti.
a. 2%
- When Coxiella burnetti is not treated and the chronic form develops there is a ____% mortality rate. The patients require a ______ replacment
a. 65%
b. Valve
- How is Coxiella burnetti disgnosed?
a. Serology (rise in antibody titer levels)
i. – IFA, CF, ELISA, microagglutination
b. • DNA detection methods
i. – PCR
c. • Isolation of organism
i. – Risk to laboratory personnel
ii. – Rarely done
d. • Clinical signs/patient history aid diagnosis
- How is Coxiella burnetti treated?
a. Doxycycline
b. –Quinolones
c. –Chronic disease – long course
i. •2 to 3 years of medication
d. • Pregnant women - co-trimoxazole (trimethoprim/sulfamethoxazole combination)
e. • Immunity –Long lasting (possibly lifelong)
- Coxiella burnetti does something unusual when it enters the macrophages for replication, that most bacteria prevent when they replicate in the macrophages… What is it?
a. Thye actively turn on the mechanisms to create Coxiella-containing vacuole (CCV)
- Coxiella burnetti can change between ______(SCVs) and ________(LCV)
a. Small cell variants
b. large cell variant
- What is a Small cell variants (SCVs)?
a. a. When inactive and not within the acidification of a host
b. Metabolically inactive
- What is the difference between a phase 1 and phase 2 organism?
a. Virulent smooth cell variants contain LPS with a complete O antigen and are referred to as phase I organisms, whereas avirulent rough cell variants lack the terminal O antigen sugars and are referred to as phase II organisms. The identification and characterization of other virulence factors has been facilitated by two recent advances: the development of axenic culture media and improvements in the tools available for genetic manipulation
- What type of phagocytosis takes place with Coxiella burnetti and what ype of macrophage does it enter?
a. Actin dependent phagocytosis
b. Alveolar macrophages
- What is αVβ3 integrin typically involved in?
a. The removal of apoptosis cells
b. Inflamation
- Although the identity of the bacterial ligand for αVβ3 integrin has not been determined, a class of likely candidates would be membrane-associated proteins that contain the integrin-binding domain ________(RGD)
a. arginine-glycine-aspartic acid
- αVβ3 integrin is poorly expressed on ______monocytes, so it is likely that C. burnetii uses other ______to invade these cells
a. resting
b. receptors
- What are the symptoms most common in animals?
a. Aymptomatic
b. Reproductive failure
c. Sheep can be chronically infected
- What is reproductive failure?
a. Abortions
b. •Stillbirths
c. •Retained placenta
d. •Infertility
e. •Weak newborns
f. •Low birth weights
- Reproductive failue commonly leads to P__________. Which is?
a. Placentitiis
b. Leathery and thickened
c. –Purulent exudate
d. •Edges of cotyledons
e. •Intercotyledonary areas
- What is a cotyledonary placenta?
a. Instead of having a single large area of contact between maternal and fetal vascular systems, these animals have numerous smaller placentae. The terminology used to describe ruminant placentation is: Cotyledon: the fetal side of the placenta.
- How does the cotyledonary placenta in an infection look like?
a. Cottage cheese
- What symptoms does the aborted feautus show?
a. None that points to a C. burnetii infection
- How is diagnosis complete?
a. – Identification of organism (Modified Ziehl-Neelson or Gimenez stains, IHC)
i. NOT Gram Stain
b. – PCR
c. – Serologic tests: IFA, ELISA, CF
d. – Isolation of organism: Hazardous - Biosafety level 3
- What Treatment is there animals?
a. Tetracycline prior to parturition
- What percentage of sheep are seropositive and cattle in endemic regions?
a. 55% sheep
b. 82% cows
- What is the prevalence of C. burnetii in the environment?
a. 23.6%
- What ways are there to control C. burnetii ?
a. Animal husbandry
b. Tick prevention
c. Destoy placenta
d. Isolate ill
e. Vaccine in countries where available
f. Pasteurisation
g. 10% bleach
h. Education
- How can C. burnetii be used as a bioweapon?
a. Aerosolised
b. Sporeforming
c. 5kg released to 5 million 125,000 ill and 150 deaths
d. Stabke in the environment
e. Only 1 organism required for infection
f. Can be blown 20km in the wind
