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Zoonoses Flashcards

1
Q

Q fever tx

A

Treat with doxycycline +/- surgery for endocarditis

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2
Q

Congo-Crimean Hemorrhagic Fever

sx

animals

location

A

– fever, hemorrhages

– tick, reservoir rodents

– Asia, Africa

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3
Q

Leptospirosis: Management

A

Doxycycline or penicillin for 1 week

• Prophylactic doxycycline 200mg weeklyi s effective in data from military clinical trials

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3
Q

Rickettsial infections

A
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4
Q

Guillain-Barr’ is due to cross reaction between

A

capsular oligosccharides and glycosphingolipids on nerve surface (autoimmune disease)

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5
Q

Yersinia pestis

• Vector

A

Xenophylla cheopis, the Rat Flea, is the main

vector; related fleas of rodents are secondary vectors

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5
Q

Ixodes sp.: Life cycle

A

Eggs hatch to larvae (spring to summer)

Larvae require a vertebrate blood meal to develop into nymphs (early fall)

  • Nymphs become dormant in winter; require another blood meal before they can become adults (spring to summer: most infectious stage)
  • Adults mate and then lay eggs (summer to fall)
  • Eggs remain dormant over the winter
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6
Q

Lassa fever characteristics

A

Arenaviruses

most common febrile illness in Sierra Leone

– African bush rat ( Mastomys natalensis )

– Transmission from urine from rats and patient body fluids ( nosocomially)

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6
Q

Flaviviruses

• Pathogenesis

A

– infect macrophages

– cell damage by cell mediators – tissue destruction by T- cell

– shock syndrome;

  • virus-antibody complex enters monocytes via Fc rec
  • antibody enhances infection
  • generally increased production of cytokines
  • severe illness, shock, hemorrhages
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7
Q

Campylobater jejuni

• Diagnosis:

A

Presence of “S” shaped bacteria in stool

• Detection of Campylobacter antigens in stool is more sensitive and specific for diagnosis

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8
Q

Campylobater jejuni

• sources

A

Worldwide round the year infections

• Poultry is the common source, ingestion of contaminated food, water and unpasteurized milk may cause diarrhea

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9
Q

Anthrax in what animals

A

Native to hoofed domestic herbivorous animals: cattle, horses, etc.

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9
Q

Brucellosis : pathogenesis

A
  • Once skin or mucous membranes are penetrated by organisms they are carried to lymphatics by PMNs
  • Cells multiply within macrophages
  • Humoral response is ineffective; T-cell response required.
  • Failure of T-cell control results in granulomatous inflammation with bacterial multiplication within the RES
  • Waves of bacteria are released into the circulation from these sites resulting in recurrent bacteremia.
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9
Q

Flaviviruses characteristics

A
  • Genome:ss+ polarity, RNA
  • Epidemiology:

– Arbovirus (except Hepatitis C )

– All flaviviruses serologically related- cross reacting antibodies

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10
Q

Tularemia found in

A

Rabbits, beavers, deer (can be found in cats and dogs)

dog tick (Dermacentor variabilis), wood tick (Dermacentor andersoni), lone star tick (Amblyomma americanum), deer flies (Chrysops spp.)

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10
Q

Anaplasmosis sx

A

>95%: fever, myalgia, headache; 75%: renal dysfunction;

• Rarely: pancarditis, myocarditis, abdominal pain, renal failure, ARDS….

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10
Q

Filoviruses type of fever

A

MHF (Marburg Hemorrhagic Fever)

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11
Q

Pasteurella multocida:Epidemiology

A

Normal respiratory biota of many lower animals,

including cats and dogs.

• Human is infected by bite ( dog commonly) or scratch

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13
Q

Faliciparum zoonotic source

A

Birds (Chickens, Ducks)

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14
Q

Yersinia pestis infection in flea vector

A
  • Flea acquires Y. pestis when it takes a blood meal from an infected rodent host.
  • Organism multiplies in proventriculus of the flea, eventually blocking the flea’s GI tract.
  • Starving flea regurgitates infectious material when attempting to take another blood meal.
  • Flea eventually dies of the infection
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14
Q

Tularemia - Diagnosis

A

history

Direct fluorescent antibody on appropriate clinical material is sufficient

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15
Q

Cat-scratch disease

A

_ Papule/pustule 3 - 10 days post cat-scratch, lick or bite.

– Fever and with regional lymphadenopathy (head, neck, axilla)

– Most cases recover completely & spontaneously

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15
Q

Q fever ( “Q” for “Query”) caused by

A

Caused by Coxiella burnetti

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16
Q

Rocky Mountain Spotted Fever carried by

A

– Dermacentor andersonii Wood Tick Western States

– Dermacentor variabilis Dog Tick Eastern States

– Ambylomma americanum Lone Star Tick Southwest

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17
Q

Diagnosis Anthrax

A

PCR

bx

culture

stain

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17
Q

Tularemia: Pathogenesis entry

A

through inhalation, ingestion, or injection

Bacteremic spread

– seeds RES > granulomatous inflammation>Ulcerated lesion develops at injection site

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18
Q

Leptospirosis: pathogenesis

A

Can get through intact skin/mucous membranes

• Prolonged immersion in contaminated waters e.g. from falling into river waters

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18
Q

Lyme Disease organism

A

(B. burgdorferi) has same range as

Ixodes sp. ticks

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18
Q

Rickettsial infections features

A
  • Primary infection in human vascular epithelium with capillary leak syndromes; adrenal glands also affected
  • Common Clinical Manifestations

– sustained high fever

– severe retro-orbital headache

– Rash (distribution and extent differs with different species)

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19
Q

Bunyaviruses

General characteristics

A

Genome:ss-RNA,3segments;S,M,L

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20
Q

Leptospirosis hosts

A

Rodent hosts esp. Rattus norvegicus

• L. ictero-haemorrhagiae is a classical parasite of rats, L. canicola of dogs, L. hebdomadis of cattle, L. pomona of pigs

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21
Q

what inhibits certain Gram-positive bacteria in maconkey agar

A

crystal violet

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23
Q

Anthrax: Clinical manifestations

A

Cutaneous: most common in humans- non lethal

Septicemic- high mortality

Pulmonary: highest mortality in humans; rare under natural circumstances: “Wool- Sorter’s Disease.”

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24
Q

Yersinia pestis animals

A

rodents

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24
Q

Filoviruses sx reservoir, location

A

– fever, rash, hemorrhage, probably disseminated intravascular coagulation

– no known reservoirs or vector

– first appeared in Marburg, Germany, 1967; lab infection from Ugandan monkeys

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25
Q

Virulence Factors: B. anthracis

A

• Lethal Factor

– tissue necrosis

• Edema Factor

– Causes infiltration and tissue swelling: enhance distribution of Lethal Factor

• Protective Antigen

– Probably the same substance as the Edema Factor with additional effect

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26
Q

Summary of Hemorrhagic Fever Viruses

A
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27
Q

Congo crimean fever characteristics

A
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28
Q

Diseases from the most common

human Bartonella spp.

A
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29
Q

Arenaviruses characteristics

A

Genome: ss - RNA, 2 segments( smaller is

ambisense )

– host ribosomes in the virus particle, no function

• Epidemiology:

– reservoir in rats of many species

– spreads through rat feces and urine – mortality ranges from 10 - 50%

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30
Q

Bacillary Angiomatosis seen in who

A

HIV

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31
Q

P. multocida: clinical Manifestations

A

infection at site of inoculation e.g. bite

  • Associated cellulitis
  • Systemic infection is uncommon but can be quite severe
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31
Q

Leptospirosis: Clinical Features

A

Initial blood stream invasion with localization in kidneys, liver, meninges and brain

• Incubation period is 1-2 weeks with 4 syndromes:

Bacteremic: flu-like, diarrhoea and vomiting; conjunctival congestion

Meningitic: like viral meningitis

Icteric: fever, hemorrhage, hepatic and renal impairment

Pulmonary:Adult Respiratory Distress Syndro

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32
Q

Tularemia: Francisella tularensis characteristics

A

Gram negative short rods

– Facultative, not spore forming

– Nutritionally fastidious: will not grow on blood or other common media; requires supplemental compounds

– Grown with Cysteine-Glucose Blood Agar (Aerobic)

– Slow growing: Requires 2 to 10 days for visible growth

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32
Q

Viral Hemorrhagic Fevers (VHFs)

viruses

A

Arena-, Bunya-, Flavi-, and Filoviridae

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33
Q

Smallpox zoonotic source

A

cattle

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33
Q

Bunyaviruses reservoirs

A

reservoir in mice, rats and ticks

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34
Q

Leptospirosis shed in

A

urine but infection is asymptomatic in animal host

34
Q

VHF-Lassa Fever tx

A

Ribavirin

35
Q

Brucellosis which one is the most infectious

A

B.melitensis

36
Q

C. burnetti shows phase variation

A

Infected source isolates – phase I, highly infectious; phase II within in-vitro culture; not infectious

38
Q

Pasteurella multocida animal

A

cats, dogs, horses

40
Q

Plague: Diagnosis/CDC

A

pre-treatment

Lymph node aspirate: An affected bubo should contain numerous organisms that can be evaluated microscopically and by culture.

Blood cultures: Organisms may be seen in blood smears if the patient is septicemic.

  • Sputum: Culture is possible from sputum of very ill pneumonic patients; however, blood is usually culture-positive at this time as well.
  • Bronchial/tracheal washing may be taken from suspected pneumonic plague patients
  • In cases where live organisms are unculturable, lymphoid, spleen, lung, liver tissue, bone marrow samples useful for direct detection methods such as direct fluorescent antibody (DFA) or PCR.
41
Q

B. burgdorferi within the tick vector

A

Borellia sp. cells adhere to epithelial cells of tick’s midgut and remain there indefinitely in a quasi- dormant state

41
Q

Lyme Stages: analogous to Syphilis

A

• Primary stage:

– ECM (Erythema Chronicum Migrans/ the target

lesion occurs in 40 - 50% of cases

• Secondary stage:

– Secondary annular skin lesions (Exanthem)

– CNS, cardiovascular, ophthalmic and musculoskeletal manifestations

• Tertiary stage:

– ACA (Acrodermatitis Chronicum Atrophicans)

– Diverse CNS symptoms, Arthritis, Cardiomyopathy

41
Q

Bunyaviruses pathogenesis

A

plasma and RBCs leak through vascular epithelium

43
Q

CCR-5 Mutation

A

Persons having one copy (heterozygous) of the gene have increased resistance to HIV

  • Persons having two copies (Homozygous) of the gene may be immune to HIV
  • This mutation has been traced back to Western Europe in the late 14th Century: The time and Place of the Black Death!
45
Q

Brucella spp animals

A

goats, cattle, swine, dogs

46
Q

Bartonella (formerly known as Rochalimaea) characteristics

A
  • Gram-negative bacteria
  • Facultative intracellular pathogens
47
Q

B. melitensis animal and location

A

goats, sheep, camels [Europe, Asia, Middle East, South & Central America]

48
Q

Lyme Disease: tx

A
  • Doxycycline or Amoxicillin for early disease
  • Ceftriaxone or Cefotaxime for late disease with

prolonged therapy.

50
Q

Brucella characteristics

A

Gram negative short rods

  • Non-motile
  • Nutritionally fastidious

– Facultative Intracellular Parasites

– Require complex artificial media in-vitro

– Slow growing (up to 10 days on Blood agar)

51
Q

Leptospirosis: Diagnosis

A

PMNs rise, liver enzymes rise, CK rise ; platelets fall

  • CSF shows a “viral pattern”
  • Isolation from blood/ urine- special media & prolonged incubation
  • Serology
  • PCR
52
Q

Scrub Typhus sx

A

Onset is sudden headache, fever, malaise, weakness and cough

  • Maculo-papular rash about 5th – 7th day trunk, face, limbs including palms and soles with generalised painless lymphadenopathy
  • Severe cases are prostrate with pneumonia, confusion ; cardiac, renal failure; hemorrhage and death
53
Q

Rocky Mountain Spotted Fever (R. rickettsii)

A
  • Incubationperiodcirca7days
  • Rash on 3rd or 4th day looking like measles
  • Skinhemorrhages
  • Hepato-splenomegaly

Rash: appears on 2nd or 3rd days on wrists or ankles and spreads inward to the trunk within hours. (Centripetal Spread); extends to cover palms of the hands and soles of the feet

55
Q

Tularemia tx

A

aminoglycoside

57
Q

Yersinia pestis: Reservoirs

A

Sylvatic Plague: Rural reservoirs of Y. pestis still exist

in several areas of the world

– Semi-arid regions of the Southwestern U.S.A.

– Southeast Asia & Grasslands of Central Asia (the

original homeland of Y. pestis)

• Not found (in significant numbers) in: Western Europe, Africa or Australia

58
Q

Korean Hemorrhagic Fever

characteristics

A

– Hemorrhagic Fever with Renal Syndrome

– mice, rats

– far east, Scandinavia, E. Europe,

– severe pulmonary syndrome in SW US (Sin Nombre)

58
Q

Filoviruses pathogeneis

A

– tissue necrosis in parenchymal cells of liver, spleen, lungs and lymph nodes

– edema and hypovolemic shock

– BCX4430, small mol. Nucleoside analogue protected monkeys from Marburg virus and MERS-Cov

59
Q

Lyme Disease: Diagnosis

A

Diagnosis:

  • B. burgdorferi in blood smear during early stage only
  • Serology for later stage is unreliable: ELISA, IFA
60
Q

How does isoxazole stop filoviruses

A

blocks protein NPC1 which is needed for replication

61
Q

Rickettsia spp. characteristics

A

gram-negative short bacillary forms

• They do not stain well with Gram’s but can be seen with Giemsa staining

intracell organisms

63
Q

Plague:

Incubation

A
  • Bubonic form is 4 to 7 days
  • Pneumonic form is 18 to 36 hours
64
Q

Venezuelan hemorrhagic fever (Guanaritovirus)

Characteristics

A

– fever, headache, sore throat, pharyngitis, loss of appetite, nausea, vomiting, seizures and nose and gum bleeding.

– reservoir in cane rats ( Zygodontomys brevicauda ) and cotton rats ( Sigmodon alstoni )

– mortality 30 - 40%

– no vaccines

– rodent control

66
Q

Yersinia pestis in what animals

A

Voles, Rats, Ground

Hogs, Rock Squirrels

68
Q

Francisella tularensis animals

A

rabbits

69
Q

Measles zoonotic source

A

Cattle (Rinderpest)

70
Q

Yellow Fever characteristics location, animal

A

Yellow Fever virus is a Flavivirus

Reservoir – monkeys; transmission from mosquitoes

Africa, South and Central America

72
Q

Anthrax is endemic in

A

sub-Saharan Africa, Asia, South and Central America, Southern and Eastern Europe

73
Q

Dengue fever- 4(5?) location

A

– India, SE Asia, Pacific, South America, and the Caribbean

75
Q

B.suis animal and location

A

pigs [South Asia]

76
Q

Tuberculosis zoonotic source

A

cattle

77
Q

Yersinia pestis: Prevention and Containment

A
  • Rat control
  • Avoid handling, skinning wild animals in endemic areas
  • 48h isolation on Rx; gowns, gloves, masks…
  • Post-exposureprophylaxiswithcaseofpneumonic infection is doxycycline 100mg or ciprofloxacin 500mg bd for 1 week
  • Inactivated vaccine does not work against pneumonic plague
78
Q

Filoviruses: Ebola disease( Ebolavirus ) characteristics

A

– sudden febrile illness, vascular collapse, internal

bleeding, death

– Incubation period: 2-21 days

– Sudan and Zaire (Democratic Republic of the Congo) ; no known vector or reservoir ? bats/primates

– 1976 first epidemic, many epidemics

– 90% mortality

79
Q

Cutaneous Anthrax : Pathogenesis:

A

 Begins at site of 1° infection as a papule; progresses through a vesicular stage to a depressed black necrotic ulcer (eschar)

 Edema, redness, and/or necrosis without ulceration may occur

 Form most commonly encountered in naturally occurring cases

 Incubation period: 1–12 days

81
Q

Pasteurella multocida characteristics

A

Gram negative short rods/short bacilli

  • Facultative;fermentscarbohydrates
  • Oxidasepositive
  • Grows readily on enriched media like Blood Agar, but not on media selective for Gram negatives (MacConkeys)
83
Q

Brucellosis: Acute Infection

A

Incubation time: 7-21 days

Onset with drenching sweat with high fever (up to 40°C.); then a swinging fever, rigors, lethargy, headache, musculo-skeletal pain; scrotal pain

Occasionally delirium, abdominal pain, constipation

• Lymphadenopathy & splenomegaly

84
Q

Ehrlichiosis/Anaplasmosis sx

A

• Symptoms include fever and GI abnormalities; severe cases progress through cough, diarrhea and lymphadenopathy up to respiratory insufficiency, renal insufficiency and CNS abnormalities.

85
Q

HEMORRHAGIC FEVERS flow

A
88
Q

How is anthrax transmitted person to person

A

cutaneous anthrax

89
Q

Acute phase of plague

A
  • Bubonic plague: swollen, painful inguinal lymph nodes; increasing fever, pooling of blood and microhemorrhages in face and extremities.
  • Pneumonic: violent and fulminating bacterial pneumonia; nearly always fatal.
90
Q

Leptospira interrogans characteristics

A
  • Tight spiral. 0.15 thick x 5 to 15 long
  • Sensitive to heat, drying and most chemicals
  • Survives well ( 1 to 2 weeks) in slightly alkaline ground water or soil, but does not multiply.
91
Q

Coxiella burnetti characteristics

A
  • Obligate intracellular parasite
  • Can survive in extracellular environment
  • Cattle, sheep, goats are important reservoirs
  • Transmission by inhalation of aerosolized particles

NO VECTOR!!

93
Q

transmission of Bartonella (formerly known as Rochalimaea)

A

• Transmission vectors include ticks, fleas, sandflies, mosquitoes

94
Q

Campylobater jejuni characteristics

A

Thin, curved gram negative rods

• Culturing requires Low Oxygen tension and higher incubation temperature ( 42oC)

95
Q

Brucellosis carried to lymphatics by

A

PMNs

96
Q

Tularemia: Clinical Presentation

A

Syndromes depend on site of infection:

– Ulcero-glandular (from injection: lowest mortality) – Typhoidal (resulting from ingestion)

– Pneumonia (from inhalation: highest mortality)

97
Q

CSF in Neuro-leptospirosis.

A

Slightlyormoderatelyincreasedprotein levels in CSF in 50% of cases.

•

Moderately increased numbers of leucocytes with prevalence of neutrophils in 50% of cases (initially) but in following days monocytes prevalent.

Glucose levels normal in 80%..

So can look like listeria or viral meningitis

98
Q

Pertussis zoonotic source

A

pigs, dogs

99
Q

Inhilation Anthrax: clinical features

A

“Flu-like” illness

Meningitis in 50% of patients

100
Q

Rocky Mountain Spotted Fever reservoir

A

– Dogs

– Wild Rodents

– The tick itself (Trans-ovarial maintenance)

101
Q

Anaplasmosis transmitted by

A

tick

102
Q

Scrub Typhus transmitted by

A

mites

103
Q

Zoonoses due to Campylobacter

A
105
Q

Yersinia pestis : Pathogenesis

A

Organism reaches lymph node where:

  • Higher temperature induces formation of virulence factors.
  • Rapid multiplication.
  • Infected lymph node swells and becomes painful: a Bubo
  • Progresses to bacteremia which seeds liver, spleen lungs and sometimes meninges
106
Q

Brucella transmission

A

Direct occupational contact: Butchers, Veterinarians. Access through skin breaks, mucus membranes, aerosols, splashes. Ingestion of infectious dairy products. Organism is killed by pasteurization.

107
Q

B. abortus- animal and location

A

cattle [Africa, Asia, South America]

108
Q

Ehrlichiosis/Anaplasmosis

• E. canis & E. chafeensis: Human Monocytic Ehrlichiosis; transmitted by

A

Disease seems to be transmitted by the Brown Dog Tick in the US (?reservoir ?vector) ; often first misdiagnosed as Rocky Mountain Spotted Fever.

109
Q

Brucellosis: Diagnosis

A

• Isolation from blood cultures; positive in 75% of

cases with B. melitensis and 50% with B. abortus

  • Bonemarrowmaybeusefulinmorechronicstate
  • CSF in neuro-infection : 30% culture positive
  • Risk to laboratory staff from culture
  • Serology
110
Q

Q fever: clinical features

A
  • Fever, headache, chills; 20% rash; pneumonia, hepatitis
  • Osteomyelitis,encephalitis,endocarditisin chronic cases
  • Diagnosis is serological; phase I and II, IgM peak at 4-6 weeks
111
Q

Brucellosis which one forms abscess

A

B. suis

112
Q

Brucellosis: Chronic infection signs

A

Prolonged cases show marked weight loss

  • Few other physical findings or signs: sometimes glandular or hepatic symptoms
  • Sacro-ileitis
  • Depression
113
Q

Scrub Typhus

• Caused by

A

Rickettsia –like organism; Orientia

tsutsugamushi

114
Q

Brucella reservoir

A

Infected animals excrete organisms for prolonged periods in milk, animal urine, feces, vaginal discharge and uterine products.

115
Q

Influenza zoonotic source

A

Pigs, Ducks

116
Q

Bacillus anthracis characteristics

A

Anthrax

large, box-car, gram-positive rod; aerobic and spore forming

117
Q

Filoviruses characteristics

A
  • Genome: ss - RNA, long filamentous virus
  • Epidemiology:

– no known reservoir

– mortality ranges from 20 - 90% – confined to Africa (?)

118
Q

Zoonotic Gram-negative bacteria

A

Brucella

Yersinia pestis

Francisella tularensis

Pasteurella multocida

119
Q

Plague: Yersinia pestis characteristics

A
  • Gram negative short rods/bacilli
  • Member of the Enterobacteriaceae:

– Gram negative non-spore forming rod

– Oxidase negative

– Facultative

– Glucose fermenter

  • Grows readily in standard media
  • Rich polysaccharide capsule present in virulent strains

Micro (14 decks)

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