Zoonoses Flashcards
What are zoonoses?
Diseases that pass between people + animals.
>70% of emerging human infectious diseases come from animals.
What are 3 examples of new emerging infectious diseases?
VHF
Resp diseases: MERS
Novel influenza viruses: pH1N1
Give 3 modes of zoonotic diseases transmission
Everyday contact: Scratches or bites
By-products (feces/urine): Contaminated soil, Litter
Foodstuffs: Carcass processing, Milk/ milking, Raw/ undercooked meats
Which zoonoses are UK farm/ wild animal associated?
Campylobacter
Salmonella
Which zoonoses are tropical farm/ wild animal associated?
Brucella
Coxiella
Rabies
VHF
Which zoonoses are UK companion animal based?
Bartonella
Toxoplasmosis
Ringworm
Psitticosis
Which zoonoses are tropical companion animal associated?
Rabies
Tick-borne diseases
Spirilum minus
What is the reservoir and transmission for Campylobacter?
Reservoir: POULTRY + Cattle
Transmission: Contaminated food
Often through cross-contamination from raw chicken.
What is the clinical presentation of Campylobacter? What are investigations and management for Campylobacter?
Diarrhoea
Bloating
Cramps
Ix: Stool culture
Mx: Supportive
What is the reservoir and transmission for Salmonella?
Reservoir: Poultry + Reptiles/ amphibians
Transmission: Contaminated food + Poor hand hygiene
What is the clinical presentation of Salmonella? What are investigations and management for Salmonella?
Diarrhoea
Vomiting
Fever
Ix: Stool culture
Mx: Supportive
Ciprofloxacin/ Azithromycin in severe
What is the reservoir and transmission of Bartonella henselae?
Reservoir: Kittens > cats
Transmission: Scratches, Bites, Licks of open wounds, Fleas
Which two diseases can Bartonella henselae cause? Generally in which groups of patients?
Cat Scratch Disease: ImmunoCOMPETENT
Bacillary angiomatosis: ImmunoCOMPROMISED
Why do kittens cause Bartonella henselae more than adult cats?
Slightly curved Gram -ve rod.
Kittens more likely to infect because they scratch more + have higher prevalence of Bartonella.
Prevalence in cats of all ages: 30-50%.
What is the clinical presentation of cat scratch disease? What are investigations and management for cat scratch disease?
Macule at site of innoculation, becomes pustular
Regional adenopathy
Systemic sx (fever, night sweats, weight loss)
Ix: Serology
Mx: Erythromycin, Doxycycline
What is the clinical presentation of bacilliary angiomatosis?
Mostly in HIV + immunosuppressed. Much more severe disease than CSD.
Skin papules (BIG)
Disseminated multi-organ + vasculature involvement
Liver: deranged LFTs, deranged clotting
Spleen: splenomegaly, thrombocytopenia, reticulocytosis, fragments on blood film
What are investigations, management and prevention recommendations for bacilliary angiomatosis?
Ix: Histopathology, Serology
Mx: Erythromycin/ Doxycycline + Rifampicin
Prevention: Wash hands after handling cats, use flea control, do not let cats lick abraded skin/ open wounds.
What is the reservoir and transmission of Toxoplasmosis?
Reservoir: Cats > Sheep
Transmission: Infected meat, Faecal contamination
What is the clinical presentation of toxoplasmosis?
Fever
Adenopathy
Still-birth
Progressive visual, hearing, motor, + cognitive issues
Seizures
Neuropathies
What is the investigation for toxoplasmosis?
Serology
What is the reservoir and transmission of Brucellosis?
Reservoir: Cattle, Goats
Transmission: Unpasteurised milk/ cheese, Undercooked meat, Mucosal splash, Aerosolisation/ inhalation
What is the clinical presentation of Brucellosis?
Incubation 5d-7m
FLAWS
PUO
Back pain
Orchitis
Focal abscesses (Psoas, liver etc)
What are investigations and management for Brucellosis?
Ix: Blood/ pus culture in casteneda medium, Serology
Mx: Doxycycline + Gentamicin/ Rifampicin
What is the reservoir and transmission of Coxiella burnetii - Q fever?
Reservoir: Goats, Sheep (Cattle)
Transmission: Aerosolisation/ inhalation of secretions, waste, or milk of infected animals, Unpasteurised milk
What is the clinical presentation of Coxiella burnetti - Q fever?
Incubation period: 2-3w (1-6w)
Fever
‘Flu-like’ illness
Pneumonia
Hepatitis
Endocarditis
Focal abscesses (Para-vertebral/discitis etc)
What are investigations and management of Coxiella burnetti - Q fever?
Ix: Serology
Mx: Doxycycline (+/-hydroxychloroquine)
What is the reservoir and transmission of Rabies (Lyssa virus)?
Reservoir: Dogs, Cats, Bats
Transmission: Bites, Scratches, Contact with infected fluid
What is the clinical presentation of Rabies?
Seizures
Excessive salivation
Agitation
Confusion
Fever
Headache
What are investigations and management of Rabies (Lyssa virus)?
Ix: Serology, Brain biopsy
(USA saliva PCR) (mainly clinical dx)
Mx: Immunoglobulin, Vaccine
HRIG only given if direct exposure to saliva of likely infected animal + no pre-exposure vx
What is the reservoir and transmission of rat bite fever?
Reservoir: Rats
Transmission: Bites, Contact with infected urine or droppings
What are the responsible agents for rat bite fever?
Streptobacillus moniliformis
Spirillum minus
What is the clinical presentation of rat bite fever?
2-10d after bite:
Fevers
Polyarthralgia
Maculopapular progressing to purpuric rash
Can progress to endocarditis
What are investigations and management for rat bite fever?
Ix: Joint fluid microscopy + culture, BC
Mx: Penicillins
What is the reservoir and transmission for Hantavirus Pulmonary Syndrome?
Reservoir:
Deer mouse: Sin Nombre virus
White footed mouse: Sin Nombre virus
Cotton rat: Black canal virus
Rice rat: Bayou virus
Transmission: Contact with infected urine or droppings, Aerosolisation
What is the clinical presentation for Hantavirus pulmonary syndrome?
Fever
Myalgia
Flu-like illness
Respiratory failure (USA)
Bleeding (SE Asia)
Renal failure (SE Asia)
What are investigations and management for Hantavirus pulmonary syndrome?
Ix: Serology, PCR
Mx: Supportive
What is the reservoir and transmission of viral haemorrhagic fever?
Reservoir:
Bats: Ebola + Marburg
Rats: Lassa
Ticks: CCHF
Transmission:
Contact of fluids of infected (saliva, urine, faeces, sweat, vomit)
What are causative organisms of viral haemorrhagic fever?
Lassa
Marburg
Ebola
Congo-Crimean Hemorrhagic Fever
Ebola + Marburg are RNA viruses in the filovirus family.
What is the clinical presentation of viral haemorrhagic fever?
Fever
Myalgia
Flu-like illness
Bleeding
What are investigations and management for viral haemorrhagic fever?
Ix: Serology, PCR
Mx: Supportive. No tx
A 35 year old patient presents with abdominal cramps and diarrhoea after a BBQ. What is the most likely source?
A. Beef
B. Pork
C. Chicken
D. Unpasteurised cheese
E. Playing with the tortoise
C. Chicken
A 35 year old patient presents with fever after a bat bite.
What potential infection is most concerning?
A. Spirillum minus
B. Hanta virus
C. Lassa virus
D. Rabies virus
E. Streptobacillus moniliformis
D. Rabies virus
A 35 year old patient is suspected of having a Brucella infection in their right psoas after drinking unpasteurised goats milk.
What is the first investigation to obtain?
A. Blood culture
B. Psoas pus culture
C. Serology
D. Whole blood PCR
E. Psoas muscle histopathology
A. Blood culture
A 35 year old patient presents with fever of 38.8C after return from 3 months in Rwanda, when they co-habited in a hut with a family and their livestock.
How should this patient be managed?
A. Admit into a bay
B. Transfer to HCID unit at Royal Free
C. Admit into side room
D. Discharge
E. Discharge to return to infectious diseases clinic in 3 days
C. Admit into side room
Name the 2 salmonella sub-species that are not zoonotic. What is their route of transmission?
Salmonella Typhi
Salmonella paratyphi
Human-Human: Faeco-oral
What % of Cat Scratch Disease patients progress? What symptoms may arise?
14%
Eye problems
Encephalopathy
Arthritis
Osteolysis
Vascular system lesions
Hepatitis
Pneumonia.
Which disease should be considered in a young person with weight loss, night sweats and has had contact with companion animals? Why?
Bartonella
Sometimes similar presentation to TB + Lymphoma
Ask if they have had contact with a cat
What is the treatment for a Toxoplasmosis +ve mother and -ve baby on PCR?
Spiramycin
3w
2-3g/d
What is the treatment for a Toxoplasmosis +ve mother and +ve baby on PCR?
Pyrimethamine + Sulfadiazine
Treat baby for up to 1y after delivery
+/- Prednisolone in severe
