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Tick Borne Disease Flashcards

1
Q
  1. Because of ________ tick borne diseases are spreading and becoming emerging and reemerging diseases .
A

a. Climate chang

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2
Q
  1. What two tick borne diseases are there?
A

a. .Crimean-Congo Haemorrhagic Fever Virus

b. Lymes Disease

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3
Q
  1. What pathogen causes CCHFV?
A

a. Crimean-Congo Haemorrhagic Fever Virus

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4
Q
  1. What genus is the Crimean-Congo Haemorrhagic Fever Virus
A

a. Nairovirus

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5
Q
  1. The Crimean-Congo Haemorrhagic Fever Virus has a great _________ diversity based on _____ location.
A

a. Genetic

b. Geographic

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6
Q
  1. What family does the CCHFV belong? Genus? Species?
A

a. Nairoviridae
b. Orthonairovirus
c. Crimean-Congo hemorrhagic fever orthonairovirus

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7
Q
  1. When was the first study of CCHFV carried out and where?
A

a. 1100 ADE

b. Tajikistan

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8
Q
  1. ____ADE: First described in Crimea. ____ (#) Soviet military personnel. Was called _____.
A

a. 1944
b. 200
c. Crimean Haemorrhagic Fever

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9
Q
  1. _______ ADE: detected in Congo
A

a. 1969

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10
Q
  1. CDC/NIAID say that CCHFV is a Category ______ pathogen and therefore has potential as a?
A

a. C

b. Bioweapon

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11
Q
  1. Where is CCHFV found? And where has the virus not been found but seropositivity? Where are there the highest number of cases?
A

a. Found:
i. Africa
ii. Middle East
iii. Asia
iv. Parts of Europe: Crimea East Europe
b. Hungary, France, Portugal
c. Crimea area

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12
Q
  1. What is the prevalence of CCHFV correlated with?
A

a. Hyalomma tick population

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13
Q
  1. What characteristics does the Hyalomma tick have?
A

a. Hard tick
b. Striped legs
c. Spread the disease
d. capitchum

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14
Q
  1. What lagitudinal lone does the CCHFV fo to? What will increase the northern stretch of this?
A

a. 50N

b. Climate change

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15
Q
  1. In _____ ADE: There were two fatalities of CCHFV in ______. In ____ADE there were 3 cases documented.
A

a. 2016
b. Spain
c. 2021

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16
Q
  1. What is the average fatality rate? And what is it dependant on? What is the range of mortality rates that have been reported? CCHFV. Mortality in the United Arab Emirates..why? China?
A

a. Case fatality rate - 30-50%
b. The out break
c. 10-80%
d. 73% far away from hospitals
e. 90% far away from hospitals

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17
Q
  1. What is a contributing factor to fatality of CCHFV?
A

a. Availability and diagnosis of hospital treatment

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18
Q
  1. What does nosocomial mean?
A

a. Acquired within a health care system

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19
Q
  1. Why is a nosocomial infection worse then getting a tick bite? CCHFV
A

a. Higher viral load

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20
Q
  1. When do outbreaks of th disease take place in Iran? Pakistan?
A

a. August and September

b. March-Ma and August-Oct

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21
Q
  1. Large herbivores, and other grazing animals, have a seropositivity from _____ to ______%? And in endemic countries and average of ____%. The issue is that most animals are _____.
A

a. 12-36%
b. 50%
c. Asymptomatic

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22
Q
  1. Circulates between asymptomatic dairy cattle and ticks in a _____?
A

a. Enzootic cycle

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23
Q
  1. Hyalomma spp. are principal vectors have three types of transmission… they be?
A

a. • Transovarial
b. • Transstadial
c. • Venereal

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24
Q
  1. What is Transovarial, Transstadial, and, Venereal?
A

a. Passes onto offspring to eggs and offspring are then infected
b. Transferred from one life stage to the next
c. Mating

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25
25. Hylamona marginatum important as a vector in what geographical locations? : Hylamona amatolicum is important vector where?
a. Europe | b. Europe
26
26. Other ixodid ticks genera that can spread the ole cimeariver disease are?
a. Rhipicephalus, Boophilus, Dermacentor and Ixodes
27
27. What other arthropods have labs found cimea disease? But they aren’t _____ vectors
a. Midges b. Soft tick c. Competent
28
28. Transmission to humans? CCHFV
a. Tick bites b. • Contact with infected, crushed ticks c. • Contact with infected animal tissues d. • Ingestion of unpasteurised milk e. • Contact with infected people i. – Blood, tissues f. Horizontal transfer g. Aerosolization in Russia
29
29. Why is it so important to pull the tick off the skin gently and not twist or burn the tick?
a. It will vomit the contents out into the blood stream b. Resulting in an immediate infection as it takes up to 48 hours for tick borne diese to cause infection form a tick that has been left on
30
30. How is the disease transmitted in Animals? CCHFV
a. Viraemic mammals can transmit CCHFV to ticks i. – Hares ii. – Hedgehogs b. • Birds resistant to infection i. – May act as mechanical vectors, transporting infected ticks ii. – Might spread virus between regions
31
31. How long can CCHFV saftleyy viable in the blood removed from human or animal?
a. 10 days 40C
32
32. Who are the most common population of CCHFV infection?
a. Health care workers b. Farmers c. Vets d. Abattoir workers e. Lab workers
33
33. What activities can lead to a risk of infection?
a. Outside walks b. Hiking c. Camping
34
34. What does Viraemic mean?
a. Virus particle in the blood flow
35
35. What si the common number of ticks that are removed from a hedge hog?
a. 500
36
36. What are the amplifying hosts of CCHFV?
a. Hares | b. Hedgehogs
37
37. What birds show no resistance to CCHFV? What percentage is seropositivwe?
a. 23% | b. Ostriches
38
38. What species do not get symptoms to CCHFV? And are responsible for transporting ticks into non-tick regions? Also called a?
a. BURBS | b. Mechanical vector
39
39. Are dogs mechanical vectors of CCHFV? And if so where
a. In some instance | b. Netherlands
40
40. How many phases does CCHFV have?
a. Three
41
41. What is the Incubation period - by route of exposure?
a. Tick bites: 1-3 day average, can be up to 13 days | b. Blood/tissues 5-6 days, can be up to 13 days
42
42. What is the first phase of CCHFV disease manifestations and called?
a. Pre-hemorrhagic phase i. – Sudden onset fever ii. – Chills, headache, dizziness iii. – Photophobia, neck pain iv. – Myalgia, arthralgia v. – Nausea, vomiting vi. – Non-bloody diarrhoea vii. – Bradycardia viii. – Low blood pressure
43
43. What is the second phase? Called? CCHFV
a. Hemorrhagic phase i. – Petechial rash ii. – Ecchymoses & large bruises iii. – Hematemesis iv. – Melena v. – Epistaxis vi. – Hematuria vii. – Hemoptysis viii. – Bleeding from other sites
44
44. What is the typical first manifectation for CCHFV?
a. Fever: quick and rapid
45
45. What illness is CCHFV confused with at the beginning? When is this a major issue
a. Meningitis | b. Countries no typically endemic for CCHFV
46
46. How long does the hemmorpggic phase of CCHFV last typically?
a. 2-3 days
47
47. What is the very first stage of CCHFV?
a. Petechial rash: small flat red dots
48
48. What is Hematemesis?
a. Vomiting blood
49
49. What is Melena?
a. Black tar poos
50
50. What is epistaxis?
a. Nose bleeds
51
51. What is hematuria?
a. Blood in urine
52
52. What is hemoptusis?
a. Coughing up blood
53
53. Swelling of the ______ can happen in the heamoragic phase of CCHFV, and patients can die from _________, _______, and _______.
a. Spleen b. Bleed out c. Cardiovascular disturbance d. Pneumonia
54
54. What is the thrids phase of CCHFV?
a. Convalescent phase
55
55. The Convalescent phase begins ____ - ______ days after the onset of illness CCHFV.
a. 10- 20
56
56. What are the disease manifestations of the Convalescent phase?
Generalised weakness b. – Tachycardia c. – Other nonspecific symptoms
57
57. Recovery from CCHFV is _____ and can take up to _______/
a. Slow | b. One year
58
58. _________ infections are uncommon with CCHFV.
a. Subclinical
59
59. What nonspecific symptoms are related to CCHFV?
a. Sweating b. dryness of the mouth c. dizzy d. naseua e. polynuritis: nerve inflammation f. hearing loss g. loss of hair (rare)
60
60. What is a new symptom of CCHFV occurring?
a. Hypata-renal failure
61
61. How are people diagnosed with CCHFV?
a. • Virus isolation and identification i. – Blood, plasma, tissues ii. – Cell culture or animal inoculation iii. – BSL-4 required b. • RT-PCR i. – Blood - highly sensitive ii. – Used for local variants c. • Serology i. – Tests detect IgM or IgG (paired titers) ii. – Indirect immunofluorescence iii. – ELISA d. • Past serologic tests i. – Complement fixation ii. – Hemagglutination
62
62. What treatment is there for CCHFV?
a. • Supportive: No direct treatment b. • Ribavirin: not designed for and not widly accepted i. – No randomised human clinical trials to support this therapy c. • Passive immunotherapy i. – Hyperimmune serum ii. – Value of treatment controversial
63
63. What BSL is required for CCHFV?
a. BSL-4 required
64
64. Why should PCR be used for diagnoses compared to the others?
a. The differences in serolgy
65
65. How many days into a CCHFV infection can a serological test be used for diagnose?
a. 7-9 days
66
66. What animals can CCHFV be found in?
a. Many species of wild & domesticated mammals i. – Hosts for immature ticks 1. • Small mammals b. – Hosts for mature ticks i. • Large herbivores ii. • Other potential hosts: mice, sheepps cattle c. – Birds mostly sero negative d. – Reptiles rarely affected: tottousie in tajikasatin got sthe bloods
67
67. What is the disease manifestation in animals and how is it diagnosed? CCHFV
a. • CCHFV infections usually asymptomatic in animals b. • Mild clinical signs possible in experimentally infected animals: very high viral load i. – Newborn rodents ii. – Sheep and cattle c. • Serology i. – IgG ELISA ii. – Complement fixation iii. – Indirect fluorescent antibody d. • Virus isolation and other techniques i. – Can detect viraemia ii. – Not used diagnostically
68
68. What prevention and controls are there for CCHFV?
a. • Avoid tick bites b. • Acaricides (animals): 50% DEET, poor ons for animals Ivermectin c. • Avoid contact with infected blood or tissues i. – Wear protective clothing & gloves d. • Food safety i. – Do not consume unpasteurised milk ii. – Virus usually inactivated in meat by post-slaughter acidification iii. – Virus also killed by cooking e. • Strict universal precautions i. – Use when caring for human patients f. • Barrier nursing g. • Isolation h. • Use of gloves, face-shields and goggles i. • Prophylactic treatment i. – Ribavirin j. • Stringent biosafety
69
69. The genetic material in the Orthonairovirus of CCHFV?
a. Segmented: 3 segments | b. Linear RNA
70
70. How many segments does the Orthonairovirus of CCHFV have and what are they called? How long are they?
a. L segment is between 6.8 and 12 kb, b. M segment between 3.2 and 4.9 kb c. S segment between 1 and 3 kb.
71
71. How many proteins does the Orthonairovirus of CCHFV encode for?
a. 4-6
72
72. What are the three segments of the RNA called? CCHFV
a. Large b. Medium c. Small
73
73. CCHFV: What does the Large, med. And Sm segment of nucleic acid code for?
a. Polymerase b. Glycoprotein dimers Gn and Gc c. Nucleoproteins
74
74. What is the route of infection with CCHFV?
a. Binds to an unknown receptor b. CME endosomal route c. pH dependent fusion and release of RNA d. 4, Primary transcription (+)mRNA e. Translation at cytosol and ER ribosomes: Movement to Golgi apparatus f. Replication of viral RNA g. Protein assemblage h. Package into a vesicle and Egress out of cell
75
75. .LD. How many people are infected every year in the US? Europe?
a. 300,000 | b. 65,00
76
76. When was limes disesed first diagnosed? And where?
a. 1975 | b. Connetiticut
77
77. What was the original limes thought to be?
a. juvenile arthritis in children
78
78. In what state did lymes disease become a reportable disease in 1985?
a. Minnesota
79
79. Where do you find lymes disease?
a. Globally
80
80. Where is the only place you don’t get lymes?
a. Antartica
81
81. What pathogen causes lymes? What is its morphology? Is it motile?
a. Motile, b. spirocchette c. .Lyme borreliosis
82
82. When length does Lyme borreliosis be?
a. 8-20
83
83. What does Lyme borreliosis have in their membranes? What role do they play?
a. OSP: outer surface proteins | b. Virulence and transmission
84
84. What is VlsE? Why is it important?
a. Surface protein on Lyme borreliosis b. Undergoes antigenic variation c. Virulence d. Aids hiding from immune response
85
85. Why is lymes reemerging in the USA?
a. Reforestation b. Overabundance of deer c. Increased number of ticks d. Expansion of suburbia into wooded areas e. Increased exposure opportunities f. Changes in diagnostic, surveillance, & reporting practices
86
86. Are deer competent hosts of lymes? And what do they act as when they are infected? What role do they play?
a. No they are not b. Dilution factor c. Reproductive host
87
87. When is there a peak of lymes disease?
a. June | b. August second one
88
88. How many cases of lymes is there reported n the UK each year? What is the estamiate of cases if all were reported?
a. 900 | b. 2-3,000
89
89. How does Lyme general manifestation happen in lymes in humans?
a. Rash – erythema migrans b. • Fever c. • Chills d. • Headache e. • Muscle and joint pain f. • Fatigue
90
90. What is the incubation period of lymes disease in humans?
a. 3-30 days
91
91. What percentage of people in the US show a Rash – erythema migrans when infected? UK?
a. 70% | b. 33%
92
92. What are the early onset manifestations of lymes in HOOOOmans?
a. Multiple rashes b. • Facial paralysis on one side c. • Fever, stiff neck, headache d. • Weakness, numbness, arm/leg pain e. • Irregular heart beat f. • Persistent weakness & fatigue
93
93. What are the late onset manifestation of lymes in hoomans?
a. Fatigue b. • Chronic arthritis c. • Nervous system problems d. Heart problems e. bells palsy
94
94. What is another name for the late onset stage of lymes? Why does this happen?
a. Dissemination | b. The bacterias is moving around the body
95
95. What approach is taken to diagnose lymes disease?
a. Two tiered approach
96
96. How does the two tiered approach to lymes diagnosis work?
a. First test: i. Ezyme immunoassay ii. Immuno fleurescence assay: False positives b. Second Test: i. <30days: IgG and IgM western blot ii. > 30days: IgG western blot
97
97. What causes false/negative positives with Immuno fleurescence assay?
a. Syphilis | b. Rheumatoid arthritis
98
98. Lyme Disease Stage Sensitivity (%)*
a. EM rash (acute) 38 b. EM rash (convalescent) 67 c. Early neurologic 87 d. Late neurologic 100 e. Arthritis 97
99
99. How is lymes treated? And for how long?
a. Antibiotics b. Ammocycylin c. Doxycycline d. 28days average or more
100
100. What is post-treatment lyme disease syndrome?
a. Pain an tiredness: debated | b. Facial palsy
101
101. Lyme disease can affect cats or dogs?
a. Dogs
102
102. What symptoms do dogs get from lymes disease?
a. Fever – 39.4-40.5oC b. – Lameness – swelling of joints, c. swollen lymph nodes, lethargy, d. Loss of appetite e. Stiff arched back
103
103. What tick affects doggos in NI?
a. Ixodes spp.
104
104. How long must Ixodes spp. tick be attached to a dog before it causes disease?
a. 24+ hours
105
105. What can happen to doggos if not treated with lymes?
a. Kidney disease and death
106
106. What is the preveleance in endemic areas?
a. Endemic areas – 6.5%-85.2% seroprevalence
107
107. What percentage of cats showed evidence of exposure? And what are they referred to as in terms of lymes?
a. 47% | b. Refactory
108
108. What treatment for dogs of lymes? How long?
a. Doxycycline – 10 mg/kg PO for 30 days b. • Penicillin (eg, amoxicillin 20 mg/kg, PO, tid) c. • Nephropathy – longer course needed d. • Prevention – Vaccine
109
109. How is lymes diagnosed in animals?
a. Clinical Signs – lameness b. • Radiograph c. • ELISA – IgM antibodies d. • Western Blot e. • Line immunoassays (LIA) f. • Fluorescent bead-based multiplex assays
110
110. How is lymes controlled?
a. Avoid tick bites b. – Tick repellents c. – Environmental modification d. – Avoidance of tick habitat e. – Examination of skin and clothing for ticks f. – Clothing to prevent tick attachment g. • Acaricides (animals) h. • Wear protective clothing and gloves
111
111. Emerging TBDs in UK/Ireland?
a. Tick-borne Encephalitis Virus(TBEV) - Single stranded RNA Virus b. • Human Anaplasmosis c. • Human Babesiosis

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