Tick Borne Disease Flashcards
- Because of ________ tick borne diseases are spreading and becoming emerging and reemerging diseases .
a. Climate chang
- What two tick borne diseases are there?
a. .Crimean-Congo Haemorrhagic Fever Virus
b. Lymes Disease
- What pathogen causes CCHFV?
a. Crimean-Congo Haemorrhagic Fever Virus
- What genus is the Crimean-Congo Haemorrhagic Fever Virus
a. Nairovirus
- The Crimean-Congo Haemorrhagic Fever Virus has a great _________ diversity based on _____ location.
a. Genetic
b. Geographic
- What family does the CCHFV belong? Genus? Species?
a. Nairoviridae
b. Orthonairovirus
c. Crimean-Congo hemorrhagic fever orthonairovirus
- When was the first study of CCHFV carried out and where?
a. 1100 ADE
b. Tajikistan
- ____ADE: First described in Crimea. ____ (#) Soviet military personnel. Was called _____.
a. 1944
b. 200
c. Crimean Haemorrhagic Fever
- _______ ADE: detected in Congo
a. 1969
- CDC/NIAID say that CCHFV is a Category ______ pathogen and therefore has potential as a?
a. C
b. Bioweapon
- Where is CCHFV found? And where has the virus not been found but seropositivity? Where are there the highest number of cases?
a. Found:
i. Africa
ii. Middle East
iii. Asia
iv. Parts of Europe: Crimea East Europe
b. Hungary, France, Portugal
c. Crimea area
- What is the prevalence of CCHFV correlated with?
a. Hyalomma tick population
- What characteristics does the Hyalomma tick have?
a. Hard tick
b. Striped legs
c. Spread the disease
d. capitchum
- What lagitudinal lone does the CCHFV fo to? What will increase the northern stretch of this?
a. 50N
b. Climate change
- In _____ ADE: There were two fatalities of CCHFV in ______. In ____ADE there were 3 cases documented.
a. 2016
b. Spain
c. 2021
- 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. Case fatality rate - 30-50%
b. The out break
c. 10-80%
d. 73% far away from hospitals
e. 90% far away from hospitals
- What is a contributing factor to fatality of CCHFV?
a. Availability and diagnosis of hospital treatment
- What does nosocomial mean?
a. Acquired within a health care system
- Why is a nosocomial infection worse then getting a tick bite? CCHFV
a. Higher viral load
- When do outbreaks of th disease take place in Iran? Pakistan?
a. August and September
b. March-Ma and August-Oct
- 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. 12-36%
b. 50%
c. Asymptomatic
- Circulates between asymptomatic dairy cattle and ticks in a _____?
a. Enzootic cycle
- Hyalomma spp. are principal vectors have three types of transmission… they be?
a. • Transovarial
b. • Transstadial
c. • Venereal
- What is Transovarial, Transstadial, and, Venereal?
a. Passes onto offspring to eggs and offspring are then infected
b. Transferred from one life stage to the next
c. Mating
- Hylamona marginatum important as a vector in what geographical locations? : Hylamona amatolicum is important vector where?
a. Europe
b. Europe
- Other ixodid ticks genera that can spread the ole cimeariver disease are?
a. Rhipicephalus, Boophilus, Dermacentor and Ixodes
- What other arthropods have labs found cimea disease? But they aren’t _____ vectors
a. Midges
b. Soft tick
c. Competent
- 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
- 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
- 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
- How long can CCHFV saftleyy viable in the blood removed from human or animal?
a. 10 days 40C
- Who are the most common population of CCHFV infection?
a. Health care workers
b. Farmers
c. Vets
d. Abattoir workers
e. Lab workers
- What activities can lead to a risk of infection?
a. Outside walks
b. Hiking
c. Camping
- What does Viraemic mean?
a. Virus particle in the blood flow
- What si the common number of ticks that are removed from a hedge hog?
a. 500
- What are the amplifying hosts of CCHFV?
a. Hares
b. Hedgehogs
- What birds show no resistance to CCHFV? What percentage is seropositivwe?
a. 23%
b. Ostriches
- 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
- Are dogs mechanical vectors of CCHFV? And if so where
a. In some instance
b. Netherlands
- How many phases does CCHFV have?
a. Three
- 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
- 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
- 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
- What is the typical first manifectation for CCHFV?
a. Fever: quick and rapid
- What illness is CCHFV confused with at the beginning? When is this a major issue
a. Meningitis
b. Countries no typically endemic for CCHFV
- How long does the hemmorpggic phase of CCHFV last typically?
a. 2-3 days
- What is the very first stage of CCHFV?
a. Petechial rash: small flat red dots
- What is Hematemesis?
a. Vomiting blood
- What is Melena?
a. Black tar poos
- What is epistaxis?
a. Nose bleeds
- What is hematuria?
a. Blood in urine
- What is hemoptusis?
a. Coughing up blood
- 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
- What is the thrids phase of CCHFV?
a. Convalescent phase
- The Convalescent phase begins ____ - ______ days after the onset of illness CCHFV.
a. 10- 20
- What are the disease manifestations of the Convalescent phase?
Generalised weakness
b. – Tachycardia
c. – Other nonspecific symptoms
- Recovery from CCHFV is _____ and can take up to _______/
a. Slow
b. One year
- _________ infections are uncommon with CCHFV.
a. Subclinical
- 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)
- What is a new symptom of CCHFV occurring?
a. Hypata-renal failure
- 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
- 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
- What BSL is required for CCHFV?
a. BSL-4 required
- Why should PCR be used for diagnoses compared to the others?
a. The differences in serolgy
- How many days into a CCHFV infection can a serological test be used for diagnose?
a. 7-9 days
- 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
- 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
- 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
- The genetic material in the Orthonairovirus of CCHFV?
a. Segmented: 3 segments
b. Linear RNA
- 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.
- How many proteins does the Orthonairovirus of CCHFV encode for?
a. 4-6
- What are the three segments of the RNA called? CCHFV
a. Large
b. Medium
c. Small
- CCHFV: What does the Large, med. And Sm segment of nucleic acid code for?
a. Polymerase
b. Glycoprotein dimers Gn and Gc
c. Nucleoproteins
- 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
- .LD. How many people are infected every year in the US? Europe?
a. 300,000
b. 65,00
- When was limes disesed first diagnosed? And where?
a. 1975
b. Connetiticut
- What was the original limes thought to be?
a. juvenile arthritis in children
- In what state did lymes disease become a reportable disease in 1985?
a. Minnesota
- Where do you find lymes disease?
a. Globally
- Where is the only place you don’t get lymes?
a. Antartica
- What pathogen causes lymes? What is its morphology? Is it motile?
a. Motile,
b. spirocchette
c. .Lyme borreliosis
- When length does Lyme borreliosis be?
a. 8-20
- What does Lyme borreliosis have in their membranes? What role do they play?
a. OSP: outer surface proteins
b. Virulence and transmission
- 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
- 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
- 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
- When is there a peak of lymes disease?
a. June
b. August second one
- 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
- 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
- What is the incubation period of lymes disease in humans?
a. 3-30 days
- What percentage of people in the US show a Rash – erythema migrans when infected? UK?
a. 70%
b. 33%
- 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
- 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
- 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
- What approach is taken to diagnose lymes disease?
a. Two tiered approach
- 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
- What causes false/negative positives with Immuno fleurescence assay?
a. Syphilis
b. Rheumatoid arthritis
- 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
- How is lymes treated? And for how long?
a. Antibiotics
b. Ammocycylin
c. Doxycycline
d. 28days average or more
- What is post-treatment lyme disease syndrome?
a. Pain an tiredness: debated
b. Facial palsy
- Lyme disease can affect cats or dogs?
a. Dogs
- 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
- What tick affects doggos in NI?
a. Ixodes spp.
- How long must Ixodes spp. tick be attached to a dog before it causes disease?
a. 24+ hours
- What can happen to doggos if not treated with lymes?
a. Kidney disease and death
- What is the preveleance in endemic areas?
a. Endemic areas – 6.5%-85.2% seroprevalence
- What percentage of cats showed evidence of exposure? And what are they referred to as in terms of lymes?
a. 47%
b. Refactory
- 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
- 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
- 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
- Emerging TBDs in UK/Ireland?
a. Tick-borne Encephalitis Virus(TBEV) - Single stranded RNA Virus
b. • Human Anaplasmosis
c. • Human Babesiosis
